Faculty Profiles - HASHIMOTO Shinichi

Papers - HASHIMOTO Shinichi

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Uehara S., Sasaki F., Sahara H., Tanaka A., Hinokuchi M., Maeda H., Arima S., Hashimoto S., Kanmura S., Ido A. . Establishment of a swine model of delayed bleeding after endoscopic procedure . DEN Open5 ( 1 ) e411 2025.4

Language：Japanese Publisher：DEN Open

Objectives: Although delayed bleeding after endoscopic procedures has become a problem, currently, there are no appropriate animal models to validate methods for preventing it. This study aimed to establish an animal model of delayed bleeding after endoscopic procedures of the gastrointestinal tract. Methods: Activated coagulation time (ACT) was measured using blood samples drawn from a catheter inserted into the external jugular vein of swine (n = 7; age, 6 months; mean weight, 13.8 kg) under general anesthesia using the cut-down method. An upper gastrointestinal endoscope was inserted orally, and 12 mucosal defects were created in the stomach by endoscopic mucosal resection using a ligating device. Hemostasis was confirmed at this time point. The heparin group (n = 4) received 50 units/kg of unfractionated heparin via a catheter; after confirming that the ACT was ≥200 s 10 min later, continuous heparin administration (50 units/kg/h) was started. After 24 h, an endoscope was inserted under general anesthesia to evaluate the blood volume in the stomach and the degree of blood adherence at the site of the mucosal defect. Results: Delayed bleeding was observed in three swine (75%) in the heparin-treated group, who had a maximum ACT of >220 s before the start of continuous heparin administration. In the non-treated group (n = 3), no prolonged ACT or delayed bleeding was observed at 24 h. Conclusion: An animal model of delayed bleeding after an endoscopic procedure in the gastrointestinal tract was established using a single dose of heparin and continuous heparin administration after confirming an ACT of 220 s.

DOI： 10.1002/deo2.411

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PubMed

Uehara Shohei, Sasaki Fumisato, Sahara Hisashi, Tanaka Akihito, Hinokuchi Makoto, Maeda Hidehito, Arima Shiho, Hashimoto Shinichi, Kanmura Shuji, Ido Akio . Establishment of a swine model of delayed bleeding after endoscopic procedure(タイトル和訳中) . DEN Open5 ( 1 ) deo2.411 - deo2.411 2025.4Establishment of a swine model of delayed bleeding after endoscopic procedure(タイトル和訳中)

Saito T., Takenaka M., Kuwatani M., Doi S., Ohyama H., Fujisawa T., Masuda A., Iwashita T., Shiomi H., Hayashi N., Iwata K., Maruta A., Mukai T., Matsubara S., Hamada T., Inoue T., Matsumoto K., Hirose S., Fujimori N., Kashiwabara K., Kamada H., Hashimoto S., Shiratori T., Yamada R., Kogure H., Nakahara K., Ogura T., Kitano M., Yasuda I., Isayama H., Nakai Y., Omoto S., Uemura S., Nakano R., Kawase Y., Takahashi S., Okuno M., Iwasa Y., Yoshida K., Ota S., Tsujimae M., Sakai A., Suda K., Takahara N., Ishigaki K., Hakuta R., Sato T., Kitano R., Kan M., Nagashima H., Iino Y., Takahashi K., Kawakubo K., Sugiura R., Kishi K., Yonemura H., Nozawa S., Nakabayashi R., Daisuke N., Hinokuchi M., Nakaji S., Nose K., Saito K., Nomura S., Fujisawa M., Kuniyoshi N., Okuda A., Ueno S., Miyano A., Nishioka N., Satta Y., Katsukura N., Itonaga M., Ashida R., Tamura T., Shishimoto T., Kawaji Y., Kato H., Sato R., Ueda K., Teramatsu K., Matsumoto K. . WONDER-02: plastic stent vs. lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic pseudocysts—study protocol for a multicentre randomised non-inferiority trial . Trials25 ( 1 ) 559 2024.12

Language：Japanese Publisher：Trials

Background: Endoscopic ultrasound (EUS)-guided transluminal drainage has become a first-line treatment modality for symptomatic pancreatic pseudocysts. Despite the increasing popularity of lumen-apposing metal stents (LAMSs), plastic stents may resolve non-necrotic fluid collections effectively with lower costs and no LAMS-specific adverse events. To date, there has been a paucity of data on the appropriate stent type in this setting. This trial aims to assess the non-inferiority of plastic stents to a LAMS for the initial EUS-guided drainage of pseudocysts. Methods: The WONDER-02 trial is a multicentre, open-label, non-inferiority, randomised controlled trial, which will enrol pancreatic pseudocyst patients requiring EUS-guided treatment in 26 centres in Japan. This trial plans to enrol 80 patients who will be randomised at a 1:1 ratio to receive either plastic stents or a LAMS (40 patients per arm). In the plastic stent group, EUS-guided drainage will be performed using two 7-Fr double pigtail stents. In the LAMS group, the treatment will be performed in the same way except for LAMS use. The step-up treatment will be performed via endoscopic and/or percutaneous procedures at the trial investigator’s discretion. The primary endpoint is clinical success, which is defined as a decrease in a pseudocyst size to ≤ 2 cm and an improvement in inflammatory indicators (i.e. body temperature, white blood cell count, and serum C-reactive protein). Secondary endpoints include technical success, adverse events including mortality, pseudocyst recurrence, and medical costs. Discussion: The WONDER-02 trial will investigate the efficacy and safety of plastic stents compared to a LAMS in EUS-guided treatment of symptomatic pancreatic pseudocysts with a particular focus on the non-inferior efficacy of plastic stents. The findings will help establish a new treatment algorithm for this population. Trial registration: ClinicalTrials.gov NCT06133023 registered on 9 November 2023. UMIN000052647 registered on 30 October 2023. jRCT1032230444 registered on 7 November 2023.

DOI： 10.1186/s13063-024-08373-6

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PubMed

Yano H, Sasaki F, Maeda H, Uehara S, Kabayama M, Fujino Y, Tanaka A, Hinokuchi M, Arima S, Hashimoto S, Kanmura S, Ito S, Nishiguchi A, Taguchi T, Ido A . Effect of sprayable, highly adhesive hydrophobized gelatin microparticles on esophageal stenosis after endoscopic submucosal dissection: an experimental study in a swine model. . Esophagus : official journal of the Japan Esophageal Society 2024.10Effect of sprayable, highly adhesive hydrophobized gelatin microparticles on esophageal stenosis after endoscopic submucosal dissection: an experimental study in a swine model.

北野雅之, 吉田真誠, 蘆田玲子, 喜多絵美里, 潟沼朗生, 糸井隆夫, 三方林太郎, 西川健一郎, 松林宏行, 高山敬子, 加藤博也, 竹中完, 植木亨, 川嶌洋平, 中井陽介, 橋元慎一, 重川稔, 根引浩子, 津村英隆, 岡部義信, 良沢昭銘, 原田宜幸, 美登路昭, 佐々木民人, 保田宏明, 三浦夏希, 池本哲也, 小澤栄介, 塩路和彦, 山口厚, 奥薗徹, 森山一郎, 久居弘幸, 藤田光一, 後藤拓磨, 白幡名香雄, 岩田恵典, 岡部純弘, 原和生, 橋本裕輔, 桑谷将城, 伊佐山浩通, 藤森尚, 正宗淳, 幡丸景一, 下川敏雄, 岡崎和一, 竹山宜典, 山上裕機, 日本膵臓学会臨床研究推進委員会 . 超音波内視鏡下組織採取後の穿刺経路腫瘍細胞播種に関する全国調査 . Gastroenterological Endoscopy66 ( 3 ) 312 - 326 2024.3超音波内視鏡下組織採取後の穿刺経路腫瘍細胞播種に関する全国調査

Language：Japanese Publisher：(一社)日本消化器内視鏡学会

【背景・目的】超音波内視鏡下組織採取法(EUS-guided tissue acquisition:EUS-TA)は,膵腫瘍の診断において重要な役割を担っている.本研究では,膵腫瘍のEUS-TA後の穿刺経路腫瘍細胞播種(Needle tract seeding:NTS)の現状を本邦の全国調査から明らかにすることを目的とした.【方法】2010年4月から2018年3月までに実施した原発性膵腫瘍に対するEUS-TA後に外科的切除を受けた患者を調査対象とした.NTSの発生率を求め,浸潤性膵管癌(Pancreatic ductal adenocarcinoma:PDAC)およびその他の腫瘍の患者,PDACの経胃・経十二指腸EUS-TAを受けた患者の間で比較した.さらに,NTS患者の詳細な特徴や予後も評価した.【結果】合計12,109人の患者が,EUS-TA後に原発性膵腫瘍の外科的切除を受けた.NTSの全発生率は0.330%であり,その発生率は他の腫瘍を有する患者よりもPDACを有する患者で有意に高かった(0.409% vs. 0.071%,P=0.004).NTSは,経胃EUS-TAを受けた患者の0.857%で観察されたが,経十二指腸EUS-TAを受けた患者の中では観察されなかった.PDACのNTSを認めた患者のうち,EUS-TAからNTSの発生までの期間の中央値および患者の生存期間の中央値は,それぞれ19.3ヵ月および44.7ヵ月であり,NTSの97.4%が胃壁に発生し,65.8%が切除された.患者生存期間は,NTS切除を行った患者では,NTS切除を行わなかった患者よりも有意に長かった(P=0.037).【結論】NTSは,経十二指腸EUS-TA後では発生せず,経胃EUS-TA後にのみ出現した.慎重な経過観察により,局所的なNTS病変を胃切除術で治療する機会が得られる.(著者抄録)

Maeda Hidehito, Sasaki Fumisato, Kabayama Masayuki, Iwaya Hiromichi, Komaki Yuga, Arima Shiho, Tanoue Shiroh, Hashimoto Shinichi, Kanmura Shuji, Miyashita Keiichi, Ohori Junichiro, Yamashita Masaru, Ido Akio . Efficacy of endoscopic ultrasonography in evaluating tumor thickness in patients with superficial pharyngeal carcinoma: A pilot study . Nippon Jibiinkoka Tokeibugeka Gakkai Kaiho(Tokyo)127 ( 1 ) 54 - 56 2024.1

KITANO Masayuki, YOSHIDA Makoto, ASHIDA Reiko, KITA Emiri, KATANUMA Akio, ITOI Takao, MIKATA Rintaro, NISHIKAWA Kenichiro, MATSUBAYASHI Hiroyuki, TAKAYAMA Yukiko, KATO Hironari, TAKENAKA Mamoru, UEKI Toru, KAWASHIMA Yohei, NAKAI Yousuke, HASHIMOTO Shinichi, SHIGEKAWA Minoru, NEBIKI Hiroko, TSUMURA Hidetaka, OKABE Yosinobu, RYOZAWA Shomei, HARADA Yoshiyuki, MITORO Akira, SASAKI Tamito, YASUDA Hiroaki, MIURA Natsuki, IKEMOTO Tetsuya, OZAWA Eisuke, SHIOJI Kazuhiko, YAMAGUCHI Atsushi, OKUZONO Toru, MORIYAMA Ichiro, HISAI Hiroyuki, FUJITA Koichi, GOTO Takuma, SHIRAHATA Nakao, IWATA Yoshinori, OKABE Yoshihiro, HARA Kazuo, HASHIMOTO Yusuke, KUWATANI Masaki, ISAYAMA Hiroyuki, FUJIMORI Nao, MASAMUNE Atsushi, HATAMARU Keiichi, SHIMOKAWA Toshio, OKAZAKI Kazuichi, TAKEYAMA Yoshifumi, YAMAUE Hiroki, Clinical Research Japan Pancreas Society on behalf of the Committee of . NEEDLE TRACT SEEDING AFTER ENDOSCOPIC ULTRASOUND-GUIDED TISSUE ACQUISITION OF PANCREATIC TUMORS: NATIONWIDE SURVEY IN JAPAN . GASTROENTEROLOGICAL ENDOSCOPY66 ( 3 ) 312 - 326 2024

Language：Japanese Publisher：Japan Gastroenterological Endoscopy Society

Objectives: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) plays a crucial role in the diagnosis of pancreatic tumors. The present study aimed to investigate the current status of needle tract seeding (NTS) after EUS-TA of pancreatic tumors based on a nationwide survey in Japan.Methods: Patients who underwent surgical resection of primary pancreatic tumors after EUS-TA performed between April 2010 and March 2018 were surveyed. The incidence rates of NTS were determined, and compared in patients with pancreatic ductal adenocarcinomas (PDACs) and other tumors, and in patients who underwent transgastric and transduodenal EUS-TA of PDACs. The detailed features and prognosis of patients with NTS were also assessed.Results: A total of 12,109 patients underwent surgical resection of primary pancreatic tumors after EUS-TA. The overall incidence rate of NTS was 0.330%, and the NTS rate was significantly higher in patients with PDAC than in those with other tumors (0.409% vs. 0.071%, P = 0.004). NTS was observed in 0.857% of patients who underwent transgastric EUS-TA, but in none of those who underwent transduodenal EUS-TA. Of the patients with NTS of PDACs, the median time from EUS-TA to occurrence of NTS and median patient survival were 19.3 and 44.7 months, respectively, with 97.4% of NTS located in the gastric wall and 65.8% of NTS resected. The patient survival was significantly longer in patients who underwent NTS resection than in those without NTS resection (P = 0.037).Conclusions: Needle tract seeding appeared only after transgastric not after transduodenal EUS-TA. Careful follow-up provides an opportunity to remove localized NTS lesions by gastrectomy.

DOI： 10.11280/gee.66.312

Scopus

Hashimoto S., Yamauchi T., Hamada T., Kojima I., Hinokuchi M., Tanoue S., Ido A. . A double-guidewire technique for endoscopic ultrasonography-guided pancreatic drainage after pancreaticoduodenectomy . Endoscopy55 ( S 01 ) E270 - E271 2023.12

Sato T., Saito T., Takenaka M., Iwashita T., Shiomi H., Fujisawa T., Hayashi N., Iwata K., Maruta A., Mukai T., Masuda A., Matsubara S., Hamada T., Inoue T., Ohyama H., Kuwatani M., Kamada H., Hashimoto S., Shiratori T., Yamada R., Kogure H., Ogura T., Nakahara K., Doi S., Chinen K., Isayama H., Yasuda I., Nakai Y. . WONDER-01: immediate necrosectomy vs. drainage-oriented step-up approach after endoscopic ultrasound-guided drainage of walled-off necrosis—study protocol for a multicentre randomised controlled trial . Trials24 ( 1 ) 352 2023.12

Language：Japanese Publisher：Trials

Background: With the increasing popularity of endoscopic ultrasound (EUS)-guided transmural interventions, walled-off necrosis (WON) of the pancreas is increasingly managed via non-surgical endoscopic interventions. However, there has been an ongoing debate over the appropriate treatment strategy following the initial EUS-guided drainage. Direct endoscopic necrosectomy (DEN) removes intracavity necrotic tissue, potentially facilitating early resolution of the WON, but may associate with a high rate of adverse events. Given the increasing safety of DEN, we hypothesised that immediate DEN following EUS-guided drainage of WON might shorten the time to WON resolution compared to the drainage-oriented step-up approach. Methods: The WONDER-01 trial is a multicentre, open-label, superiority, randomised controlled trial, which will enrol WON patients aged ≥ 18 years requiring EUS-guided treatment in 23 centres in Japan. This trial plans to enrol 70 patients who will be randomised at a 1:1 ratio to receive either the immediate DEN or drainage-oriented step-up approach (35 patients per arm). In the immediate DEN group, DEN will be initiated during (or within 72 h of) the EUS-guided drainage session. In the step-up approach group, drainage-based step-up treatment with on-demand DEN will be considered after 72–96 h observation. The primary endpoint is time to clinical success, which is defined as a decrease in a WON size to ≤ 3 cm and an improvement of inflammatory markers (i.e. body temperature, white blood cell count, and C-reactive protein). Secondary endpoints include technical success, adverse events including mortality, and recurrence of the WON. Discussion: The WONDER-01 trial will investigate the efficacy and safety of immediate DEN compared to the step-up approach for WON patients receiving EUS-guided treatment. The findings will help us to establish new treatment standards for patients with symptomatic WON. Trial registration: ClinicalTrials.gov NCT05451901, registered on 11 July 2022. UMIN000048310, registered on 7 July 2022. jRCT1032220055, registered on 1 May 2022.

DOI： 10.1186/s13063-023-07377-y

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PubMed

Sasaki F., Mawatari S., Oda K., Yano H., Maeda H., Tanaka A., Arima S., Kumagai K., Tanoue S., Hashimoto S., Kanmura S., Ido A. . Usefulness of the aldehyde breath test for predicting metachronous recurrence in patients with esophageal squamous cell carcinoma and hypopharyngeal squamous cell carcinoma . Esophagus20 ( 4 ) 749 - 756 2023.10

Language：Japanese Publisher：Esophagus

Background: The rate of metachronous recurrence after endoscopic submucosal dissection for early-stage esophageal squamous cell carcinoma and hypopharynx squamous cell carcinoma is as high (10–15%). The acetaldehyde breath test may detect acetaldehyde dehydrogenase 2 gene polymorphisms. Therefore, we evaluated its usefulness in assessing metachronous recurrence in patients with esophageal squamous cell carcinoma and hypopharynx squamous cell carcinoma. Methods: A total of 76 patients underwent endoscopic submucosal dissection for esophageal squamous cell carcinoma and hypopharynx squamous cell carcinoma and were followed up for at least 3 years (non-recurrence group: 52 patients; recurrence group: 24 patients). The risk factors for carcinogenesis were compared between the recurrence and non-recurrence groups, and the acetaldehyde-to-ethanol ratio was assessed. The cutoff acetaldehyde-to-ethanol ratio that correlated with recurrence was established, and the cumulative recurrence rate was evaluated. Results: The recurrence group had a higher acetaldehyde-to-ethanol ratio, daily alcohol consumption, and Lugol-voiding lesion grade than the non-recurrence group in the univariate analysis. The cutoff acetaldehyde-to-ethanol ratio for recurrence was 28.1 based on the receiver operating characteristic curve. The multivariate analysis revealed an acetaldehyde-to-ethanol ratio of > 28.1 and a Lugol-voiding lesion grade associated with carcinogenesis. Patients with an acetaldehyde-to-ethanol ratio of ≥ 28.1 had a significantly high recurrence rate using the Kaplan–Meier method. Conclusions: The acetaldehyde-to-ethanol ratio detected using the acetaldehyde breath test could be a novel biomarker of metachronous recurrence after endoscopic submucosal dissection in patients with esophageal squamous cell carcinoma and hypopharynx squamous cell carcinoma. Trial registration number: UMIN000040615.

DOI： 10.1007/s10388-023-01024-w

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PubMed

Sasaki Fumisato, Mawatari Seiichi, Oda Kohei, Yano Hiroki, Maeda Hidehito, Tanaka Akihito, Arima Shiho, Kumagai Kotaro, Tanoue Shiroh, Hashimoto Shinichi, Kanmura Shuji, Ido Akio . 食道扁平上皮癌および下咽頭扁平上皮癌の患者における異時性再発の予測に対するアルデヒド呼気試験の有用性(Usefulness of the aldehyde breath test for predicting metachronous recurrence in patients with esophageal squamous cell carcinoma and hypopharyngeal squamous cell carcinoma) . Esophagus20 ( 4 ) 749 - 756 2023.10食道扁平上皮癌および下咽頭扁平上皮癌の患者における異時性再発の予測に対するアルデヒド呼気試験の有用性(Usefulness of the aldehyde breath test for predicting metachronous recurrence in patients with esophageal squamous cell carcinoma and hypopharyngeal squamous cell carcinoma)

Language：English Publisher：シュプリンガー・ジャパン(株)

アセトアルデヒド呼気試験はアセトアルデヒド脱水素酵素2の遺伝子多型を同定する可能性があるため、食道および下咽頭扁平上皮癌患者における異時性再発を発見する上での有用性を評価した。内視鏡的粘膜下層剥離術を受けた76例の食道および下咽頭扁平上皮癌患者を少なくとも3年間経過観察した。再発が認められなかった症例が52例(非再発群)、認められた症例が24例(再発群)であった。癌発生の危険因子を再発群と非再発群で比較し、アセトアルデヒド-エタノール比を測定した。再発と関連するアセトアルデヒド-エタノール比のカットオフ値を設定し、累積再発率を評価した。単変量解析の結果、再発群では、アセトアルデヒド-エタノール比、1日当たりのアルコール消費量、ルゴール不染帯グレードが非再発群と比較して高かった。受信者動作特性曲線解析を用いた。その結果、アセトアルデヒド-エタノール比のカットオフ値は28.1であった。多変量解析の結果、アセトアルデヒド-エタノール比>28.1およびルゴール不染帯グレードが癌の発生と関連していた。カプランマイヤー法による検討では、アセトアルデヒド-エタノール比≧28.1の症例の再発率が有意に高かった。以上より、アセトアルデヒド呼気試験により求められるアセトアルデヒド-エタノール比が、食道および下咽頭扁平上皮癌患者における内視鏡的粘膜下層剥離術後の異時性再発に対する新規バイオマーカーとなる可能性が示された。

Maeda Nobuhisa, Tanoue Shiroh, Fujino Yusuke, Hinokuchi Makoto, Arima Shiho, Sasaki Fumisato, Hashimoto Shinichi, Kanmura Shuji, Higashi Michiyo, Ido Akio . Focal Type 2 Autoimmune Pancreatitis Mimicking Pancreatic Cancer: Treatment with Neoadjuvant Chemotherapy and Surgery . Internal Medicine62 ( 17 ) 2499 - 2505 2023.9

Language：English Publisher：The Japanese Society of Internal Medicine

A 51-year-old man was referred to our hospital for the further examination of main pancreatic duct interruption. Imaging findings showed a 25-mm-diameter mass lesion located in the pancreatic head. Endoscopic ultrasonography (EUS)-guided fine-needle aspiration (FNA) was performed on the mass. Cytology suggested adenocarcinoma, but the histological diagnosis was not confirmed. We made a comprehensive diagnosis of resectable pancreatic cancer. The mass shrank after preoperative adjuvant chemotherapy, and the patient underwent surgery. The final pathological diagnosis was type 2 autoimmune pancreatitis (AIP). Two years after surgery, AIP had not recurred in the remaining pancreas.

DOI： 10.2169/internalmedicine.0224-22

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PubMed

Maeda Nobuhisa, Tanoue Shiroh, Fujino Yusuke, Hinokuchi Makoto, Arima Shiho, Sasaki Fumisato, Hashimoto Shinichi, Kanmura Shuji, Higashi Michiyo, Ido Akio . 膵癌とよく似た所見を示す限局性2型自己免疫性膵炎　術前補助化学療法と手術による治療(Focal Type 2 Autoimmune Pancreatitis Mimicking Pancreatic Cancer: Treatment with Neoadjuvant Chemotherapy and Surgery) . Internal Medicine62 ( 17 ) 2499 - 2505 2023.9膵癌とよく似た所見を示す限局性2型自己免疫性膵炎　術前補助化学療法と手術による治療(Focal Type 2 Autoimmune Pancreatitis Mimicking Pancreatic Cancer: Treatment with Neoadjuvant Chemotherapy and Surgery)

Language：English Publisher：(一社)日本内科学会

症例は51歳男性で、MR胆管膵管撮影で主膵管途絶が明らかになり、精査目的で紹介来院した。入院時に腹部症状はなく、バイタルサインは安定していた。全身造影CTでは、膵頭に径25mmの腫瘤性病変が認められ、膵頭での主膵管途絶および膵尾領域での主膵管拡張が判明した。FDG-PETでは膵頭病変で異常蓄積が認められた。超音波内視鏡ガイド下穿刺吸引を行い、細胞診では膵腺癌が示唆されたが、組織学的診断は確定できなかった。炎症性腸疾患がないことを確認後、包括的に切除可能膵癌と診断した。ゲムシタビン+TS-1による術前補助化学療法を3コース行った。その結果、腫瘍径が25mmから16mmに縮小した。幽門輪温存膵頭十二指腸切除術を行って腫瘍を切除した。最終的な病理学的診断は2型自己免疫性膵炎(AIP)であった。術後2年時点で残存膵にAIP再発は認めていない。

橋元慎一, 樋之口真, 井戸章雄 . 特集1 令和にアップデートしたい膵癌の画像診断画像診断の進歩:EUS . 臨床画像39 ( 7 ) 766 - 774 2023.7特集1 令和にアップデートしたい膵癌の画像診断画像診断の進歩:EUS

Murakami Masatoshi, Fujimori Nao, Nakata Kohei, Nakamura Masafumi, Hashimoto Shinichi, Kurahara Hiroshi, Nishihara Kazuyoshi, Abe Toshiya, Hashigo Shunpei, Kugiyama Naotaka, Ozawa Eisuke, Okamoto Kazuhisa, Ishida Yusuke, Okano Keiichi, Takaki Ryo, Shimamatsu Yutaka, Ito Tetsuhide, Miki Masami, Oza Noriko, Yamaguchi Daisuke, Yamamoto Hirofumi, Takedomi Hironobu, Kawabe Ken, Akashi Tetsuro, Miyahara Koichi, Ohuchida Jiro, Ogura Yasuhiro, Nakashima Yohei, Ueki Toshiharu, Ishigami Kousei, Umakoshi Hironobu, Ueda Keijiro, Oono Takamasa, Ogawa Yoshihiro . Machine learning-based model for prediction and feature analysis of recurrence in pancreatic neuroendocrine tumors G1/G2(タイトル和訳中) . Journal of Gastroenterology58 ( 6 ) 586 - 597 2023.6Machine learning-based model for prediction and feature analysis of recurrence in pancreatic neuroendocrine tumors G1/G2(タイトル和訳中)

Language：English Publisher：シュプリンガー・ジャパン(株)

切除した膵神経内分泌腫瘍(PanNEN)は再発率が高いので、その予測因子を検索した。22医療機関で1987年1月～2020年7月に切除したPanNEN573例のデータベースを作成した。局在性の非機能性膵神経内分泌腫瘍(G1/G2)の371名の患者の臨床的特徴を分析した。再発を決定付ける特徴を分析するため、機械学習予測モデルを構築した。経過観察中に患者52名に再発がみられ、再発までの中央値は33.7ヵ月であった。ランダムサバイバルフォレスト(RSF)モデルはCox比例ハザード回帰モデルよりもHarrell C指数が優れていた。Ki-67指数、残存腫瘍、WHOグレード、腫瘍サイズ、リンパ節転移がRSFモデルの上位5予測因子で、腫瘍サイズ20mm以上が再発の可能性の上昇する分岐点で、Ki-67指数の上昇とともに5年無増悪生存率が直線的に低下した。

Murakami M., Fujimori N., Nakata K., Nakamura M., Hashimoto S., Kurahara H., Nishihara K., Abe T., Hashigo S., Kugiyama N., Ozawa E., Okamoto K., Ishida Y., Okano K., Takaki R., Shimamatsu Y., Ito T., Miki M., Oza N., Yamaguchi D., Yamamoto H., Takedomi H., Kawabe K., Akashi T., Miyahara K., Ohuchida J., Ogura Y., Nakashima Y., Ueki T., Ishigami K., Umakoshi H., Ueda K., Oono T., Ogawa Y. . Machine learning-based model for prediction and feature analysis of recurrence in pancreatic neuroendocrine tumors G1/G2 . Journal of Gastroenterology58 ( 6 ) 586 - 597 2023.6

Language：Japanese Publisher：Journal of Gastroenterology

Background: Pancreatic neuroendocrine neoplasms (PanNENs) are a heterogeneous group of tumors. Although the prognosis of resected PanNENs is generally considered to be good, a relatively high recurrence rate has been reported. Given the scarcity of large-scale reports about PanNEN recurrence due to their rarity, we aimed to identify the predictors for recurrence in patients with resected PanNENs to improve prognosis. Methods: We established a multicenter database of 573 patients with PanNENs, who underwent resection between January 1987 and July 2020 at 22 Japanese centers, mainly in the Kyushu region. We evaluated the clinical characteristics of 371 patients with localized non-functioning pancreatic neuroendocrine tumors (G1/G2). We also constructed a machine learning-based prediction model to analyze the important features to determine recurrence. Results: Fifty-two patients experienced recurrence (14.0%) during the follow-up period, with the median time of recurrence being 33.7 months. The random survival forest (RSF) model showed better predictive performance than the Cox proportional hazards regression model in terms of the Harrell’s C-index (0.841 vs. 0.820). The Ki-67 index, residual tumor, WHO grade, tumor size, and lymph node metastasis were the top five predictors in the RSF model; tumor size above 20 mm was the watershed with increased recurrence probability, whereas the 5-year disease-free survival rate decreased linearly as the Ki-67 index increased. Conclusions: Our study revealed the characteristics of resected PanNENs in real-world clinical practice. Machine learning techniques can be powerful analytical tools that provide new insights into the relationship between the Ki-67 index or tumor size and recurrence.

DOI： 10.1007/s00535-023-01987-8

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Hinokuchi Makoto, Hashimoto Shinichi, Kojima Issei, Nakamura Yoshitaka, Fujita Toshihiro, Iwashita Yuji, Arima Shiho, Tanoue Shiroh, Ohtsuka Takao, Ido Akio . Efficacy and safety of a novel anti-reflux metal stent during neoadjuvant chemotherapy for pancreatic cancer: A prospective multicenter exploratory study(タイトル和訳中) . Journal of Hepato-Biliary-Pancreatic Sciences30 ( 4 ) 532 - 541 2023.4Efficacy and safety of a novel anti-reflux metal stent during neoadjuvant chemotherapy for pancreatic cancer: A prospective multicenter exploratory study(タイトル和訳中)

Language：English Publisher：John Wiley & Sons Australia, Ltd

新規ダックビル型逆流防止弁付き金属ステント(D-ARMS)による胆道ドレナージの安全性および有効性を前向きに評価した。ネオアジュバント化学療法施行予定のD-ARMS治療が実施された切除可能または境界切除可能膵癌患者33例(男性23例、中央値68歳)、従来の被覆自己拡張型金属ステント(CCSEMS)による治療が実施された38例(男性27例、中央値67.5歳)を解析対象とした。評価項目は技術的・臨床的成功、Recurrent biliary obstruction(RBO)発生率、RBO累積発生率とした。その結果、技術的成功率は両群ともに100%であり、臨床的成功率にも有意差は認められなかった(93.9%対89.5%、P=0.68)。多変量解析の結果、D-ARMSはRBO累積発生の独立した予測因子であった(P=0.03)。RBO累積発生率はCCSEMS群と比較してD-ARMS群で有意に低かった(P=0.04)。以上から、D-ARMSはネオアジュバント化学療法施行患者にとって安全かつ有用であることが示された。

Hinokuchi M., Hashimoto S., Kojima I., Nakamura Y., Fujita T., Iwashita Y., Arima S., Tanoue S., Ohtsuka T., Ido A. . Efficacy and safety of a novel anti-reflux metal stent during neoadjuvant chemotherapy for pancreatic cancer: A prospective multicenter exploratory study . Journal of Hepato-Biliary-Pancreatic Sciences30 ( 4 ) 532 - 541 2023.4

Language：Japanese Publisher：Journal of Hepato-Biliary-Pancreatic Sciences

Background/Purpose: The benefits of anti-reflux metal stents, used for treating biliary obstruction in patients receiving neoadjuvant chemotherapy (NAC) for pancreatic cancer, are yet unknown. Herein, the safety and efficacy of the novel duckbill-type anti-reflux metal stent (D-ARMS) were prospectively evaluated for biliary drainage. Additionally, the incidence of recurrent biliary obstruction (RBO) after placement of D-ARMS vs conventional covered self-expandable metal stents (CCSEMSs) was retrospectively compared. Methods: Patients who received D-ARMS (n = 33) for treatment of distal biliary obstruction before NAC between September 2019 and January 2021 and those that received CCSEMSs (n = 38) between January 2013 and August 2019 were included in the historical control group. Technical and clinical successes, rate of RBO, and cumulative incidence of RBO were compared between the two groups. Results: The technical success rate was 100% for both the D-ARMS and CCSEMS groups, and the clinical success rate were not significantly different (93.9% and 89.5%, respectively; P =.68). In the multivariate analysis, D-ARMS was identified as the independent factor for cumulative incidence of RBO (P =.03). The cumulative incidence of RBO was significantly lower in the D-ARMS group than that in the CCSEMS group (P =.04). Conclusions: D-ARMS is safe and effective for patients receiving NAC.

DOI： 10.1002/jhbp.1239

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Kabayama M., Sasaki F., Hidehito M., Fujino Y., Yano H., Tanaka A., Arima S., Tanoue S., Hashimoto S., Kanmura S., Hirade H., Nishiguchi A., Taguchi T., Ido A. . Effects of Sprayable, Highly Adhesive Hydrophobized Gelatin Microparticles on Endoscopic Submucosal Dissection: A Swine Model . Digestion104 ( 2 ) 137 - 147 2023.3

Language：Japanese Publisher：Digestion

Introduction: Sprayable wound dressings containing hydrophobized microparticles (hMPs) are characterized by strong adhesiveness. We examined the effect of hMPs derived from Alaska pollock gelatin on endoscopic submucosal dissection (ESD) ulcers. Methods: (1) In an in vivo model of miniature swine gastric ESD, gastric ulcers were created by ESD and then sprayed with hMPs or untreated followed by microscopic examination. (2) In an ex vivo ESD model of resected stomach, a pinhole-shaped perforation was created on the ESD ulcer of resected stomach; hMPs were then sprayed on the perforation; and air leakage and intragastric pressure were measured. (3) In an in vivo duodenal ESD model of miniature swine, duodenal artificial ESD ulcers with pinhole-shaped perforation were examined; ulcers were classified into hMPs-sprayed and nonsprayed groups, and inflammation in the intrinsic muscle layer and serosa were compared between the groups. Results: (1) Histological observation of submucosal tissues showed a decreased number of invading inflammatory cells in hMP-sprayed tissues compared with the control in miniature swine gastric ESD (p < 0.05). In addition, the rates of anti-alpha smooth muscle actin and type I collagen positivity were significantly lower in the hMPs group than in the control group (p < 0.05). (2) Intragastric pressure could not be measured in the nonsprayed group, whereas no air leakage was observed in the sprayed group when pressurized up to 26 mm Hg in the resected stomach model. (3) The sprayed group showed suppressed inflammation of the intrinsic muscular layer and serosa in both cases compared with the nonsprayed group in miniature swine duodenal ESD (p < 0.05). Conclusions: Sprayable, tissue-adhesive hMPs are a promising medical material for intraoperative and postoperative treatment of ESD-induced wound via anti-inflammation and strong adhesiveness.

DOI： 10.1159/000526650

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Iwaya H., Tanimoto A., Toyodome K., Kojima I., Hinokuchi M., Tanoue S., Hashimoto S., Kawahira M., Arima S., Kanmura S., Akahane T., Higashi M., Suzuki S., Ueno S., Ohtsuka T., Ido A. . Next-Generation Sequencing Analysis of Pancreatic Cancer Using Residual Liquid Cytology Specimens from Endoscopic Ultrasound—Guided Fine-Needle Biopsy: A Prospective Comparative Study with Tissue Specimens . Diagnostics13 ( 6 ) 2023.3

Language：Japanese Publisher：Diagnostics

This study evaluated the feasibility and clinical utility of liquid-based cytology (LBC) specimens via endoscopic ultrasound–guided fine-needle biopsy (EUS-FNB) for next-generation sequencing (NGS) of pancreatic cancer (PC). We prospectively evaluated the performance of DNA extraction and NGS using EUS-FNB samples obtained from PC. Thirty-three consecutive patients with PC who underwent EUS-FNB at our hospital were enrolled. DNA samples were obtained from 96.8% of the patients. When stratified with a variant allele frequency (VAF) > 10% tumor burden, the NGS success rate was 76.7% (n = 23) in formalin-fixed paraffin-embedded (FFPE), 83.3% (n = 25) in LBC, and 76.7% (n = 23) in frozen samples. The overall NGS success rate was 86.7% (n = 26) using FFPE, LBC, or frozen samples. The detection rates for the main mutated genes were as follows: 86.7% for KRAS, 73.3% for TP53, 66.7% for CDKN2A, 36.7% for SMAD4, and 16.7% for ARID1A. LBC had the highest median value of VAF (23.5%) for KRAS and TP53. PC mutation analysis using NGS was successfully performed using LBC compared with FFPE and frozen samples. This approach provides an alternative and affordable source of molecular testing materials.

DOI： 10.3390/diagnostics13061078

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Hashimoto S., Iwashita Y., Taguchi H., Tanoue S., Ohi T., Shibata R., Haraguchi T., Kamikihara Y., Toyodome K., Kojima I., Araki N., Tsuneyoshi K., Nakamura Y., Fujita T., Hinokuchi M., Iwaya H., Arima S., Sasaki F., Kanmura S., Ido A. . Comparison of recurrent biliary obstruction with the use of metal and plastic stents in EUS-guided biliary drainage: A propensity score-matched analysis . Endoscopic Ultrasound12 ( 1 ) 64 - 73 2023.1

Language：Japanese Publisher：Endoscopic Ultrasound

Background and Objectives: In transpapillary biliary drainage, metal stents (MSs) exhibit a lower incidence of a biliary obstruction than plastic stents (PSs). However, few studies have compared recurrent biliary obstruction (RBO) when MSs and PSs are used in EUS-guided hepaticogastrostomy (EUS-HGS) and choledochoduodenostomy (EUS-CDS). We retrospectively evaluated the RBO for both stents in each procedure. Patients and Methods: Between November 2012 and December 2020, 85 and 53 patients who underwent EUS-HGS and EUS-CDS for unresectable malignant biliary obstruction, respectively, were enrolled. Factors associated with RBO were assessed. Clinical outcomes were compared between the MS and PS groups using propensity score matching. Results: The clinical success rate and procedure-related adverse events were similar in the MS and PS groups. Multivariate analysis identified the use of PS as a factor associated with RBO (EUS-HGS, P = 0.03; EUS-CDS, P = 0.02). After matching, the median time to RBO in EUS-HGS (MS: 313; PS: 125 days; P = 0.01) in the MS group was longer than that in the PS group. The cumulative incidence of RBO at 1, 3, and 6 months in the MS group was significantly lower than that in the PS group for EUS-HGS (MS: 4.0%, 8.2%, and 8.2%; PS: 12.4%, 24.9%, and 39.5%, respectively, P = 0.01). Conclusions: MS exhibited a lower rate of RBO than PS for EUS-HGS and EUS-CDS.

DOI： 10.4103/EUS-D-21-00251

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Fujisaki Y., Fukukura Y., Kumagae Y., Ejima F., Yamagishi R., Nakamura S., Kamizono J., Kurahara H., Hashimoto S., Yoshiura T. . Value of Dual-Energy Computed Tomography for Detecting Small Pancreatic Ductal Adenocarcinoma . Pancreas51 ( 10 ) 1352 - 1358 2022.11

Language：Japanese Publisher：Pancreas

Objective The aim of the study is to evaluate the usefulness of virtual monoenergetic imaging (VMI) generated from dual-energy computed tomography (DECT) in detecting small pancreatic ductal adenocarcinomas (PDACs). Methods This study included 82 patients pathologically diagnosed with small PDAC (≤30 mm) and 20 without pancreatic tumors who underwent triple-phase contrast-enhanced DECT. To assess diagnostic performance for small PDAC detection via a receiver operating characteristic analysis, 3 observers reviewed 2 image sets (conventional computed tomography [CT] set and combined image set [conventional CT + 40-keV VMI from DECT]). The tumor-To-pancreas contrast-To-noise ratio was compared between conventional CT and 40-keV VMI from DECT. Results The area under the receiver operating characteristic curve of the 3 observers were 0.97, 0.96, and 0.97 in conventional CT set and 0.99, 0.99, and 0.99 in combined image set (P = 0.017-0.028), respectively. The combined image set yielded a better sensitivity than the conventional CT set (P = 0.001-0.023), without a loss of specificity (all P > 0.999). The tumor-To-pancreas contrast-To-noise ratios of 40-keV VMI from DECT were approximately threefold higher than those of conventional CT at all phases. Conclusions The addition of 40-keV VMI from DECT to conventional CT had better sensitivity for detecting small PDACs without compromising specificity.

DOI： 10.1097/MPA.0000000000002207

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Kitano M., Yoshida M., Ashida R., Kita E., Katanuma A., Itoi T., Mikata R., Nishikawa K., Matsubayashi H., Takayama Y., Kato H., Takenaka M., Ueki T., Kawashima Y., Nakai Y., Hashimoto S., Shigekawa M., Nebiki H., Tsumura H., Okabe Y., Ryozawa S., Harada Y., Mitoro A., Sasaki T., Yasuda H., Miura N., Ikemoto T., Ozawa E., Shioji K., Yamaguchi A., Okuzono T., Moriyama I., Hisai H., Fujita K., Goto T., Shirahata N., Iwata Y., Okabe Y., Hara K., Hashimoto Y., Kuwatani M., Isayama H., Fujimori N., Masamune A., Hatamaru K., Shimokawa T., Okazaki K., Takeyama Y., Yamaue H., Abue M., Aiura K., Akashi T., Akiyama T., Aoyagi H., Araki M., Arizumi T., Aruga Y., Asada M., Asai S., Baba T., Ban S., Chinen K., Doi S., Eguchi T., Endo M., Endo S., Ezaki T., Fujii K., Fujii M., Fujimori M., Fujimoto Y., Fujita Y., Fujita Y., Fukasawa M., Fukuba N., Fukuchi S., Fukuda K., Furukawa M., Furumatsu K., Hakamada K., Hanada K., Harada K., Harano M., Hashigo S., Hashiguchi K., Hayashi K., Hayashi N., Hayatsu S., Hijioka S., Hirano A., Hirao M., Hirooka Y., Hirota M., Horino K., Hotta Y., Ijima M., Ikuta Y., Imakiire K., Imamura T., Inatomi O. . Needle tract seeding after endoscopic ultrasound-guided tissue acquisition of pancreatic tumors: Nationwide survey in Japan . Digestive Endoscopy34 ( 7 ) 1442 - 1455 2022.11

Language：Japanese Publisher：Digestive Endoscopy

Objectives: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) plays a crucial role in the diagnosis of pancreatic tumors. The present study aimed to investigate the current status of needle tract seeding (NTS) after EUS-TA of pancreatic tumors based on a nationwide survey in Japan. Methods: Patients who underwent surgical resection of primary pancreatic tumors after EUS-TA performed between April 2010 and March 2018 were surveyed. The incidence rates of NTS were determined, and compared in patients with pancreatic ductal adenocarcinomas (PDACs) and other tumors, and in patients who underwent transgastric and transduodenal EUS-TA of PDACs. The detailed features and prognosis of patients with NTS were also assessed. Results: A total of 12,109 patients underwent surgical resection of primary pancreatic tumors after EUS-TA. The overall incidence rate of NTS was 0.330%, and the NTS rate was significantly higher in patients with PDAC than in those with other tumors (0.409% vs. 0.071%, P = 0.004). NTS was observed in 0.857% of patients who underwent transgastric EUS-TA, but in none of those who underwent transduodenal EUS-TA. Of the patients with NTS of PDACs, the median time from EUS-TA to occurrence of NTS and median patient survival were 19.3 and 44.7 months, respectively, with 97.4% of NTS located in the gastric wall and 65.8% of NTS resected. The patient survival was significantly longer in patients who underwent NTS resection than in those without NTS resection (P = 0.037). Conclusions: Needle tract seeding appeared only after transgastric not after transduodenal EUS-TA. Careful follow-up provides an opportunity to remove localized NTS lesions by gastrectomy.

DOI： 10.1111/den.14346

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Kitano Masayuki, Yoshida Makoto, Ashida Reiko, Kita Emiri, Katanuma Akio, Itoi Takao, Mikata Rintaro, Nishikawa Kenichiro, Matsubayashi Hiroyuki, Takayama Yukiko, Kato Hironari, Takenaka Mamoru, Ueki Toru, Kawashima Yohei, Nakai Yousuke, Hashimoto Shinichi, Shigekawa Minoru, Nebiki Hiroko, Tsumura Hidetaka, Okabe Yosinobu, Ryozawa Shomei, Harada Yoshiyuki, Mitoro Akira, Sasaki Tamito, Yasuda Hiroaki, Miura Natsuki, Ikemoto Tetsuya, Ozawa Eisuke, Shioji Kazuhiko, Yamaguchi Atsushi, Okuzono Toru, Moriyama Ichiro, Hisai Hiroyuki, Fujita Koichi, Goto Takuma, Shirahata Nakao, Iwata Yoshinori, Okabe Yoshihiro, Hara Kazuo, Hashimoto Yusuke, Kuwatani Masaki, Isayama Hiroyuki, Fujimori Nao, Masamune Atsushi, Hatamaru Keiichi, Shimokawa Toshio, Okazaki Kazuichi, Takeyama Yoshifumi, Yamaue Hiroki . 超音波内視鏡ガイド下膵臓腫瘍組織採取後の穿刺経路播種　日本で行った全国調査(Needle tract seeding after endoscopic ultrasound-guided tissue acquisition of pancreatic tumors: Nationwide survey in Japan) . Digestive Endoscopy34 ( 7 ) 1442 - 1455 2022.11超音波内視鏡ガイド下膵臓腫瘍組織採取後の穿刺経路播種　日本で行った全国調査(Needle tract seeding after endoscopic ultrasound-guided tissue acquisition of pancreatic tumors: Nationwide survey in Japan)

Language：English Publisher：John Wiley & Sons Australia, Ltd

原発膵臓腫瘍に対する超音波内視鏡ガイド下組織採取(EUS-TA)後の穿刺経路播種(NTS)の現状を、日本の全国調査を基に明らかにした。EUS-TA後に膵臓腫瘍の外科的切除を施行された患者12109例を対象に、NTSの全発生率を調査した。また当該患者を、膵管腺癌(PDAC)とその他の膵臓腫瘍群、PDACに対する経胃的および経十二指腸的EUS-TAを行った患者群に分け、播種発生率を比較した。さらにNTS患者の特徴と予後も評価した。NTSの全発生率は0.330%で、PDAC患者で有意に高かった。NTSは、経胃的EUS-TA施行患者の0.857%で観察されたが、経十二指腸的EUS-TA施行患者では観察されなかった。PDACのEUS-TA後にNTSを発生した患者38例(男性23例、女性15例、年齢中央値71歳)では、36例の原発腫瘍が膵体および膵尾部に位置し、EUS-TAからNTSの発生まで時間中央値は19.3ヵ月、生存期間中央値は44.7ヵ月であった。またNTSの97.4%が胃壁にあり、65.8%が切除された。患者生存率は、NTS切除非施行患者よりもNTS切除施行患者の方が有意に長かった。NTSは経胃的EUS-TA後のPDAC患者の約0.9%で検出されたが、経十二指腸的EUS-TA施行患者では検出されなかった。

Yokoyama S., Iwaya H., Akahane T., Hamada T., Higashi M., Hashimoto S., Tanoue S., Ohtsuka T., Ido A., Tanimoto A. . Sequential evaluation of MUC promoter methylation using next-generation sequencing-based custom-made panels in liquid-based cytology specimens of pancreatic cancer . Diagnostic Cytopathology50 ( 11 ) 499 - 507 2022.11

Language：Japanese Publisher：Diagnostic Cytopathology

Background: As liquid-based cytology (LBC) specimens preserve high-quality DNA, clinical sequencing of LBC specimens using next-generation sequencing (NGS) is becoming a common strategy. This study aimed to evaluate the feasibility of NGS-based custom-made panels for evaluating MUC promoter methylation in LBC specimens. Methods: Thirty-one patients with pancreatic cancer were enrolled in the study. Cancer tissue samples were obtained using endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB). LBC, formalin-fixed paraffin-embedded (FFPE), and fresh frozen specimens were prepared for DNA extraction after pathological diagnosis. These specimens were then subjected to NGS analysis using custom-made cancer gene screening and methylation panels comprising 28 cancer-related genes and 13 gene promoter regions, including MUC1, MUC2, and MUC4. Results: The success rate of NGS using the cancer gene panel was comparable among the LBC, FFPE, and frozen specimens, and the presence of cancer cell-derived somatic mutations in each specimen was confirmed. The specimens were then tested using a methylation panel that revealed the sequential methylation status of CpG islands located in the promoter regions of MUC genes. The methylation status results obtained from LBC specimens were almost comparable with those from FFPE and frozen specimens. Conclusions: MUC and other gene methylation analyses using an NGS-based panel were successfully performed in residual LBC specimens obtained by EUS-FNA/FNB. Therefore, this approach provides an alternative source of molecular tests for gene mutations and methylation, especially in the pancreatic cancers, which are often unresectable and unsuitable for obtaining FFPE specimens.

DOI： 10.1002/dc.25022

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Maeda H., Sasaki F., Kabayama M., Iwaya H., Komaki Y., Arima S., Tanoue S., Hashimoto S., Kanmura S., Miyashita K., Ohori J., Yamashita M., Ido A. . Efficacy of endoscopic ultrasonography in evaluating tumor thickness in patients with superficial pharyngeal carcinoma: A pilot study . Auris Nasus Larynx49 ( 3 ) 495 - 503 2022.6

Language：Japanese Publisher：Auris Nasus Larynx

Objectives: A histopathological tumor thickness of ≥1000 μm has been reported as one of many risk factors for recurrent lymph node metastasis in superficial pharyngeal cancer (SPC). However, methods for assessing this risk factor preoperatively have not yet been established. Hence, the current study aimed to evaluate the efficacy of endoscopic ultrasonography (EUS) in measuring tumor thickness preoperatively in patients with SPC. Methods: This single-center retrospective study included 44 consecutive patients with 47 lesions who underwent endoscopic submucosal dissection (ESD). Prior to surgery, EUS examination was performed while under general anesthesia. Further, microvascular irregularity in the target lesion was evaluated using the Japan Esophageal Society (JES) magnification endoscopic classification system. Results: A significant correlation was noted between histopathological and EUS tumor thickness (Spearman's correlation r == 0.879, p < 0.001). In tumors ≥1000 µm thick on histopathology, the cutoff value for EUS tumor thickness was 2.6 mm, and the following values were obtained: sensitivity, 100%; specificity, 81.8%; positive predictive value (PPV), 70%; negative predictive value (NPV), 100%; and accuracy, 87.2%. In B2 lesions ≥1000-μm thick, the following values were obtained: sensitivity, 85.7%; specificity, 90.9%; PPV, 80%; NPV, 93.8%; and accuracy, 89.4%. The diagnostic accuracy rate of combined EUS and the JES magnifying endoscopic classification system was 95.7%. Conclusions: Tumor thickness assessed using EUS was effective in diagnosing histopathological tumor thickness of ≥1000 μm. The combined use of EUS and the JES magnifying endoscopic classification system may be useful for assessing preoperative risk factors for lymph node metastasis in SPC.

DOI： 10.1016/j.anl.2021.11.003

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Maeda Hidehito, Sasaki Fumisato, Kabayama Masayuki, Iwaya Hiromichi, Komaki Yuga, Arima Shiho, Tanoue Shiroh, Hashimoto Shinichi, Kanmura Shuji, Miyashita Keiichi, Ohori Junichiro, Yamashita Masaru, Ido Akio . 咽頭表在癌患者での腫瘍厚評価における超音波内視鏡検査の有効性　パイロット試験(Efficacy of endoscopic ultrasonography in evaluating tumor thickness in patients with superficial pharyngeal carcinoma: A pilot study) . Auris・Nasus・Larynx49 ( 3 ) 495 - 503 2022.6咽頭表在癌患者での腫瘍厚評価における超音波内視鏡検査の有効性　パイロット試験(Efficacy of endoscopic ultrasonography in evaluating tumor thickness in patients with superficial pharyngeal carcinoma: A pilot study)

Language：English Publisher：(一社)日本耳鼻咽喉科頭頸部外科学会

咽頭表在癌では腫瘍の厚さがリンパ節転移再発の危険因子の一つであることが報告されている。その厚さを術前に測定する目的で超音波内視鏡検査(EUS)が示す有用性を評価した。2010年12月～2018年3月に当院で咽頭表在癌に対し内視鏡的粘膜下層剥離術を施行し、その直前に全身麻酔下でEUSも実施していた連続患者44名(男性43名、平均67.8±8.7歳)の47病変を組み入れた。EUSで測定した腫瘍厚と、術後、病理組織学的に評価された腫瘍厚とは有意に相関していた(Spearmanの相関係数r=0.88、p<0.001)。病理評価の厚が1000μm以上であることの予測に最適となるEUS測定厚のカットオフ値を受信者動作特性(ROC)解析で求めたところ2.6mmと決定された。そのカットオフ値が示した感度は100%、特異度は82%、陽性的中率は70%、陰性的中率は100%、精度は89%となった。さらに日本食道学会の拡大内視鏡分類システムをEUSと組み合わせて使用した場合、その診断精度は96%となった。EUS評価による腫瘍厚は、病理組織学的計測での腫瘍厚が1000μm以上であることを診断するのに有効であった。咽頭表在癌に対しEUSと拡大内視鏡分類システムを併用すれば、リンパ節転移再発の術前危険因子の評価に有用であると考えられた。

Komaki Y., Kanmura S., Yutsudo K., Kuwazuru K., Komaki F., Tanaka A., Maeda H., Arima S., Tanoue S., Sasaki F., Hashimoto S., Horiuchi M., Ido A. . Clinical features of obscure gastrointestinal bleeding undergoing capsule endoscopy: A retrospective cohort study . PLoS ONE17 ( 3 March ) e0265903 2022.3

Language：Japanese Publisher：PLoS ONE

Background Capsule endoscopy has been widely used to investigate obscure gastrointestinal bleeding (OGIB) in the small intestine since its approval in 2001. However, the clinical features of OGIB remain unclear. Aim We retrospectively examined the clinical features and risk factors of OGIB in patients who underwent capsule endoscopy in our hospital. Methods We included 420 of the 431 patients who underwent capsule endoscopy from June 2014 to May 2021, in whom the small intestine could be observed. We retrospectively compared the clinical features and treatment of OGIB cases, with or without active small bowel bleeding (n = 173), with other cases (n = 247). Patient sex, age, diabetes mellitus, and heart failure histories were matched for the analysis. Results The male/female ratio was 247/173 and the average age was 51.54 years. In multivariate analysis, the use of direct oral anticoagulants was significant (P = 0.016), and vascular lesions (P = 0.018) were observed in OGIB cases. When OGIB cases with and without active small bowel bleeding were compared, serum albumin level was lower in cases with active bleeding (P = 0.031). When treatment of OGIB cases were compared, those without vascular lesions could be treated conservatively (P = 0.0047). In the 1:1 propensity score matching analysis, serum creatinine level was elevated in cases of active bleeding (P = 0.029), and cases without vascular lesions were treated conservatively (P = 0.010). Conclusions Use of direct oral anticoagulants is frequently associated with OGIB. OGIB patients without vascular lesions may be treated conservatively.

DOI： 10.1371/journal.pone.0265903

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橋元慎一, 柿原敦子, 児島一成, 松岡慧, 荒木紀匡, 樋之口真, 有馬志穂, 田ノ上史郎, 井戸章雄 . 特集内視鏡的乳頭切除術まるわかり [各論] EP後の晩期偶発症とその治療 . 消化器内視鏡34 ( 1 ) 109 - 114 2022.1特集内視鏡的乳頭切除術まるわかり [各論] EP後の晩期偶発症とその治療

Tanoue S., Kanmura S., Hinokuchi M., Arima S., Sasaki F., Hashimoto S., Ido A. . Role of apoptosis inhibitor of macrophages in patients with IgG4-related disease/autoimmune pancreatitis and the clinical characteristics associated with this condition . Biomedical Reports17 ( 4 ) 82 2022

Language：Japanese Publisher：Biomedical Reports

Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD) and is a unique chronic inflammatory disease characterized by fibrosis. IgG4-RD is caused by an autoimmune mechanism that mimics malignant tumors and inflammatory disorders. Apoptosis inhibitor of macrophages (AIM) can function as a biomarker of autoimmune or inflammatory diseases with tissue fibrosis, including in inflammatory bowel disease and chronic liver disease. Therefore, the aim of the present study was to clarify the role of serum AIM levels and the clinical characteristics of patients with IgG4-RD and AIP. For this purpose, serum AIM concentrations were assessed using ELISA and the association between AIM and the laboratory and clinical data from patients with IgG4-RD/AIP, patients with pancreatic cancer (PC) and healthy controls (HCs), was determined. The results demonstrated that the serum AIM concentrations were not associated with the laboratory data. However, the serum AIM levels were significantly elevated in patients with AIP compared with the HCs and patients with PC. Furthermore, the serum AIM levels significantly decreased following steroid therapy in patients with AIP who were in remission. Overall, the present study demonstrates that serum AIM levels may be a potentially useful biomarker for the differential diagnosis of AIP and for evaluating the therapeutic reactivity of affected patients.

DOI： 10.3892/br.2022.1565

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Kozono M., Tanoue S., Kiyama K., Jikuya K., Kawahira M., Hinokuchi M., Iwaya H., Arima S., Hashimoto S., Hiwatashi K., Fukuda Y., Sakoda M., Higashi M., Tokushige K., Ido A. . A case of immunoglobulin G4-related sclerosing mesenteritis without other organ involvement . Clinical Journal of Gastroenterology14 ( 5 ) 1411 - 1418 2021.10

Language：Japanese Publisher：Clinical Journal of Gastroenterology

A 64-year-old man presented to our hospital with abdominal pain and 4–5 episodes of watery diarrhea per day for 2 months. Abdominal ultrasound examination revealed a mass in the peritoneal cavity, and computed tomography showed a 13.4 cm mass in the mesentery and a 3 cm mass in the mesocolon. The patient underwent laparoscopic partial resection for diagnosis. Microscopically, abundant fibrosis and numerous immunoglobulin (Ig) G4-positive plasma cells were observed. The serum level of IgG4 was 665 mg/dl postoperatively. These findings suggested that the lesion was consistent with IgG4-related sclerosing mesenteritis. Oral steroids resulted in rapid disappearance of symptoms and a decrease in masses. Recently, sclerosing mesenteritis are reported as IgG4-related disease or mimicking IgG4-related disease but multiple lesions rarely occur in the same organ. We report a case of IgG4-related sclerosing mesenteritis with multiple lesions without involvement of other organs, such as the pancreas and salivary glands.

DOI： 10.1007/s12328-021-01451-1

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Kozono Masaya, Tanoue Shiroh, Kiyama Kanna, Jikuya Kenichi, Kawahira Machiko, Hinokuchi Makoto, Iwaya Hiromichi, Arima Shiho, Hashimoto Shinichi, Hiwatashi Kiyokazu, Fukuda Yoshio, Sakoda Masahiko, Higashi Michiyo, Tokushige Koichi, Ido Akio . 他臓器侵襲を伴わない免疫グロブリンG4関連硬化性腸間膜炎の1例(A case of immunoglobulin G4-related sclerosing mesenteritis without other organ involvement) . Clinical Journal of Gastroenterology14 ( 5 ) 1411 - 1418 2021.10他臓器侵襲を伴わない免疫グロブリンG4関連硬化性腸間膜炎の1例(A case of immunoglobulin G4-related sclerosing mesenteritis without other organ involvement)

Language：English Publisher：シュプリンガー・ジャパン(株)

症例は64歳男性で、2ヵ月前から臍部周辺の腹痛と毎週4～5回の水様便を呈して当院を受診した。身体所見では腹部は軟性で軽度圧痛があり、頻回な腸管運動がみられた。また、臨床検査で軽度貧血、CRPの軽度上昇、可溶性IL-2の増加が認められた。腹部超音波検査にて腹腔内に10cm大の腫瘤が検出され、造影CTでは上腸間膜と横行結腸間膜に軟部組織腫瘤を認め、多発性の小結節が腫瘤周囲に存在していた。このほか、MRI検査にてT1強調像で低信号、脂肪抑制T2強調像で軽度高信号を呈する上腸間膜腫瘤が認められた。なお、造影CTでは他臓器侵襲は確認されず、PET-CTは施行しなかった。腹腔鏡アプローチにて病理診断を行ったところ、術中所見では小腸間膜に腫瘍を認め腹膜腫瘤を形成しており可動性に乏しかった。腫瘍末梢側に多数の黄色結節がみられ、術中迅速病理検査で非定型細胞が検出された。組織診では多量のIgG4陽性形質細胞が中隔に観察され、IgG4関連硬化性腸間膜炎を示唆する所見であった。経口ステロイド療法としてプレドニゾロン0.5mg/kgを開始したところ、下痢と腹部症状は急速に改善し、1ヵ月後には完全消失が得られた。治療開始6ヵ月後、症状の再燃や腫瘤の再増殖は認めていない。

Iwaya H, Kojima I, Hinokuchi M, Hashimoto S, Tanoue S, Kanmura S, Ido A . Novel biliary stenting with an antireflux system for distal biliary obstruction in a patient with a surgically altered anatomy. . Endoscopy international open9 ( 10 ) E1561 - E1562 2021.10Novel biliary stenting with an antireflux system for distal biliary obstruction in a patient with a surgically altered anatomy.

Kuwatani M., Kawakubo K., Sugimori K., Inoue H., Kamada H., Ishiwatari H., Kato S., Iwashita T., Yoshida M., Hashimoto S., Itonaga M., Mizukami Y., Nomura Y., Katanuma A., Sakamoto N. . Trial protocol: A randomised controlled trial to verify the non-inferiority of a partially covered self-expandable metal stent to an uncovered self-expandable metal stent for biliary drainage during neoadjuvant therapy in patients with pancreatic cancer with obstructive jaundice (PUN-NAC trial) . BMJ Open11 ( 7 ) e045698 2021.7

Language：Japanese Publisher：BMJ Open

Introduction Neoadjuvant chemotherapy or neoadjuvant chemoradiotherapy (NAC/NACRT) for resectable/borderline resectable pancreatic cancers was recently performed to improve clinical outcomes and led to good results, although it remains controversial whether NAC/NACRT is beneficial for resectable pancreatic cancer. A few recent studies revealed longer patency and lower cost related to the stent occlusion of a metal stent than those of a plastic stent during NAC/NACRT. It also remains controversial which type of self-expandable metal stent (SEMS) is the most suitable for patients with resectable/borderline resectable pancreatic cancer during NAC/NACRT: an uncovered SEMS (USEMS), a fully covered SEMS (FCSEMS) or a partially covered SEMS (PCSEMS). So far, two randomised controlled trials indicated that a USEMS and an FCSEMS were similar in preoperative stent dysfunction and adverse event rate. Thus, we aimed to verify the non-inferiority of a PCSEMS to a USEMS in this multicentre randomised controlled trial. Methods and analysis We designed a multicentre randomised controlled trial, for which we will recruit 100 patients with resectable/borderline resectable pancreatic cancer and distal biliary obstruction scheduled for NAC/NACRT from 13 high-volume institutions. Patients will be randomly allocated to the PCSEMS group or USEMS group. The primary outcome measure is the preoperative biliary event rate. Data will be analysed after completion of the study. We will calculate the 95% CIs of the incidence of preoperative biliary events in each group and analyse whether the difference between them is within the non-inferiority margin (10%). Ethics and dissemination This study has been approved by the institutional review board of Hokkaido University Hospital. The results will be submitted for presentation at an international medical conference and published in a peer-reviewed journal. Trial registration number UMIN000041737; jRCT1012200002.

DOI： 10.1136/bmjopen-2020-045698

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Taguchi H., Otsuka T., Shimokawa M., Arima S., Hashimoto S., Ido A., Koga F., Ueda Y., Nakazawa J., Komori A., Otsu S., Fukahori M., Makiyama A., Honda T., Shibuki T., Mizuta T., Mitsugi K., Nio K., Ide Y., Ureshino N., Shirakawa T. . Gemcitabine plus nanoparticle albumin-bound paclitaxel versus FOLFIRINOX for recurrent pancreatic cancer after resection . Anticancer Research41 ( 7 ) 3573 - 3582 2021.7

Language：Japanese Publisher：Anticancer Research

Background/Aim: The aim of the study was to evaluate gemcitabine plus nanoparticle albumin-bound paclitaxel (GnP) and FOLFIRINOX for recurrent pancreatic cancer (rPC) after resection. Patients and Methods: Forty-four patients with rPC and 211 with de novo metastatic pancreatic cancer (mPC) who received GnP or FOLFIRINOX as first-line chemotherapy were retrospectively analyzed. Results: On crude analysis, the median overall survival (OS) was significantly longer in the rPC group than in the mPC group (14.0 vs. 10.6 months, respectively; p=0.02). However, the difference was not significant on adjusted analysis using the Cox proportional hazards model (adjusted p=0.90). Patients receiving FOLFIRINOX (n=10) and GnP (n=34) in the rPC group had comparable OS (medians, 12.2 vs. 14.4 months, respectively; p=0.82) even after adjusting for covariates using the Cox model (adjusted p=0.18). Conclusion: The outcomes of patients in the rPC and mPC groups were comparable following chemotherapy. Both FOLFIRINOX and GnP may be reasonable options for treating rPC.

DOI： 10.21873/anticanres.15145

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Toyodome Koshiro, Taguchi Hiroki, Hinokuchi Makoto, Fujita Toshihiro, Iwaya Hiromichi, Iwashita Yuji, Tanoue Shiroh, Hashimoto Shinichi, Nagata Yuki, Hatanaka Shingo, Higashi Michiyo . A case of communicating accessory bile duct with double cystic ducts and a fibrous polyp in the bile duct . Tando35 ( 2 ) 188 - 196 2021.5

Language：Japanese Publisher：Japan Biliary Association

A 66-year-old woman was referred to our department for the examination of a pancreatic cyst. Endoscopic ultrasonography showed a tumor in the bile duct and another duct communicating with the bile duct. Cholangiography revealed the bile ducts forming a circuit, double cystic ducts, and a defect suspected of the bile duct tumor. Communicating accessory bile ducts (CABDs) and a fibrous polyp were diagnosed based on the imaging and pathological findings. After subtotal stomach-preserving pancreaticoduodenectomy, CABDs were histologically confirmed. We report a rare case of CABD with double cystic ducts and a bile duct fibrous polyp.

DOI： 10.11210/tando.35.188

豊留孝史郎, 田口宏樹, 樋之口真, 藤田俊浩, 岩屋博道, 岩下祐司, 田ノ上史郎, 橋元慎一, 永田祐貴, 畠中真吾, 東美智代 . 重複胆嚢管様の胆道走行および胆管線維性ポリープを伴った、副交通胆管枝(communicating accessory bile duct)の1例 . 胆道35 ( 2 ) 188 - 196 2021.5重複胆嚢管様の胆道走行および胆管線維性ポリープを伴った、副交通胆管枝(communicating accessory bile duct)の1例

Language：Japanese Publisher：(一社)日本胆道学会

症例は66歳女性.腹部超音波検査で膵頭部嚢胞が疑われ当科を受診した.MRCP,EUSで総胆管および近傍に胆管と思われる管腔構造を認めた.造影EUSでは,胆管内に多血性の低エコー腫瘤を認め,胆管腫瘍の合併も疑われた.胆管造影では,胆管内は隔壁様の構造で隔たれ環状構造を形成しており,副交通胆管枝(communicating accessory bile duct:CABD)と診断した.また,胆嚢管は2本に分岐し,それぞれの胆管に合流し,重複胆嚢管類似の胆道走行を認めた.胆管内には輪郭不整な透亮像を認め,腫瘍生検結果は線維性ポリープであった.亜全胃温存膵頭十二指腸切除術が施行され,術後病理標本では,膵上縁より上流のレベルで重複した胆管上皮を認め,CABDに矛盾しない所見であった.CABDと重複胆嚢管類似の複雑な胆道構造および,胆管線維性ポリープを合併した症例を報告する.(著者抄録)

Kanmura S. . Increased Gene Copy Number of DEFA1A3 Is Associated With the Severity of Ulcerative Colitis . Clinical and translational gastroenterology12 ( 4 ) e00331 2021.4

Language：Japanese Publisher：Clinical and translational gastroenterology

INTRODUCTION:DEFA1A3 encodes human neutrophil peptides (HNPs) 1-3 and has multiple copy number variations (CNVs). HNPs are associated with innate immunity. Ulcerative colitis (UC), a chronic inflammatory gastrointestinal disorder, is a life-threatening condition, and predictive markers of UC severity are needed. This study investigated the relationship between DEFA1A3 CNV and UC severity.METHODS:This study enrolled 165 patients with UC. The relationship between DEFA1A3 CNV and disease severity was analyzed based on Mayo score, patient characteristics, and treatment methods. In addition, serum and stimulated neutrophil-derived HNP concentrations were also measured in patients with high and low DEFA1A3 CNV.RESULTS:DEFA1A3 CNV was significantly correlated with Mayo score and white blood cell count (R = 0.46, P < 0.0001; R = 0.29, P = 0.003, respectively), and only high copy numbers of DEFA1A3 were independent factors for severe UC (P < 0.001, odds ratio: 1.88, 95% confidence interval, 1.34-2.61). The number of severe UC patients with high DEFA1A3 CNV was significantly greater than those with low CNV. We confirmed the associations between DEFA1A3 and UC severity using a validation cohort. In addition, the HNP concentration in high-copy number patients was significantly higher after neutrophil stimulation than that in low-copy number patients.DISCUSSION:This study demonstrated that there is a correlation between DEFA1A3 copy number and severity in patients with UC. In addition, neutrophils from UC patients with higher DEFA1A3 CNV had high reactivity of secretion of HNPs after stimulation. DEFA1A3 CNV may be a novel severity marker and a potential therapeutic target for UC.

DOI： 10.14309/ctg.0000000000000331

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Iwaya H. . Prognostic significance of extracellular volume fraction with equilibrium contrast-enhanced computed tomography for pancreatic neuroendocrine neoplasms . Pancreatology21 ( 4 ) 779 - 786 2021

Language：Japanese Publisher：Pancreatology

Background: /Objectives: Identifying reliable pretreatment imaging biomarkers for pancreatic neuroendocrine neoplasm (PanNEN) is a key imperative. Extracellular volume (ECV) fraction quantified with equilibrium contrast-enhanced CT can be easily integrated into routine examinations. This study aimed to determine whether ECV fraction with equilibrium contrast-enhanced computed tomography (CECT) could predict long-term outcomes in patients with PanNEN. Methods: This study was a retrospective observational study of 80 patients pathologically diagnosed with PanNEN at a single institution. ECV fraction of the primary lesion was calculated using region-of-interest measurement within PanNEN and the aorta on unenhanced and equilibrium CECT. The impact of clinical factors and tumor ECV fraction on progression-free survival (PFS) and overall survival (OS) was assessed with univariate and multivariate analyses using Cox proportional hazards models. The correlation between WHO classification and tumor ECV fraction was evaluated using Kendall rank correlation coefficients. Results: PFS and OS rates were estimated as 93.4% and 94.6%, 78.7% and 86.2%, 78.7% and 77.0%, and 78.7% and 66.6% at 1, 3, 5, and 10 years, respectively. Multivariate analysis revealed that Union for International Cancer Control (UICC) stage (hazard ratio [HR] = 3.95, P = 0.003), WHO classification (HR = 12.27, P = 0.003), and tumor ECV fraction (HR = 11.93, P = 0.039) were independent predictors of PFS. Patient age (HR = 1.11, P < 0.001), UICC stage (HR = 3.14, P = 0.001), and tumor ECV fraction (HR = 5.27, P = 0.024) were independent significant variables for predicting OS. Tumor ECV fraction had a weak inverse relationship with WHO classification (P = 0.045, τ = −0.178). Conclusions: ECV fraction determined by equilibrium CECT and UICC stage may predict survival in patients with PanNEN.

DOI： 10.1016/j.pan.2021.02.020

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Sasaki F, Kanmura S, Oda K, Maeda H, Kabayama M, Iwaya H, Komaki Y, Arima S, Tanoue S, Hashimoto S, Fujita H, Ido A . Acetaldehyde breath test as a cancer risk marker in patients with esophageal and hypopharyngeal squamous cell carcinoma. . PloS one16 ( 5 ) e0251457 2021

Language：Japanese Publisher：PLoS ONE

Patients with inactive acetaldehyde dehydrogenase 2 (ALDH2) are at high risk for esophageal squamous cell carcinoma (ESCC) and hypopharyngeal squamous cell carcinoma (HPSCC). The acetaldehyde breath test (ABT) may demonstrate ALDH2 gene polymorphisms. We evaluated the usefulness of the ABT in patients with ESCC and HPSCC. The squamous cell carcinoma (SCC) group consisted of 100 patients who were treated with endoscopic submucosal dissection (ESD) for ESCC or HPSCC, and the control group (HC) consisted of 275 healthy subjects. The SCC group comprised the "single subgroup"(n = 63), in which a single lesion was initially treated with ESD, and the "multiple subgroup"(n = 31), in which multiple lesions were initially treated with ESD. First, we compared the groups' risk factors for carcinogenesis and measured the acetaldehyde-to-ethanol (A/E) ratio. Then we tested the groups' differences in the abovementioned carcinogenic risk factors. We found that the proportion of individuals in the SCC group with inactive ALDH2 (A/E ratio ≥ 23.3) was significantly higher than that in the HC group (p = 0.035), as was the A/E ratio (p < 0.001). Also, the proportion of individuals with inactive ALDH2 in the multiple subgroup was significantly higher than that in single subgroup (p = 0.015), as was the A/E ratio (p = 0.008). In conclusion, ABT may be a potential screening tool for detecting people at risk of ESCC and HPSCC. In addition, it could be a useful tool in detecting patients at risk of multiple or double carcinomas among patients with ESCC and HPSCC.

DOI： 10.1371/journal.pone.0251457

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Nakazawa J. . Analysis of factors affecting progression-free survival of first-line chemotherapy in older patients with advanced gastrointestinal cancer . Journal of Geriatric Oncology12 ( 8 ) 1200 - 1207 2021

Language：Japanese Publisher：Journal of Geriatric Oncology

Objectives: Few studies have investigated factors influencing the efficacy of chemotherapy in older patients with cancer. This study aimed to evaluate the usefulness of G8, geriatric assessment (GA), and factors measured in general clinical practice for evaluating progression-free survival (PFS) of first-line palliative chemotherapy in older patients with advanced gastrointestinal cancer. Materials and methods: This was a prospective observational study of older patients (age ≥70 years) with advanced gastrointestinal cancer. The modified cut-off value of G8 was determined by referring to two or more abnormal GA conditions. The usefulness of baseline GA and G8 (conventional and modified cut-off value) was assessed according to the efficacy (PFS and disease control rate) of the administered first-line palliative chemotherapy. Results: Overall, 93 patients were evaluated between March 2017 and February 2019. A modified G8 cut-off value of ≤12 had a sensitivity and specificity of 68.9% and 46.9%, respectively. PFS was significantly prolonged in the patients with G8 > 12, serum albumin ≥3.5 g/dl, and in whom grade ≥3 adverse events occurred. There was no significant difference in the PFS between monotherapy and combination therapy. GA was not useful for predicting PFS prolongation or the occurrence of serious adverse events in first-line treatment. Conclusion: Among older patients with advanced gastrointestinal cancer who receive first-line chemotherapy, a modified G8 cut-off value of 12 points, occurrence of grade 3 or higher adverse events, albumin levels, rather than age or performance status were predictors of PFS prolongation.

DOI： 10.1016/j.jgo.2021.05.006

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矢野弘樹, 橋元慎一, 田口宏樹, 田ノ上史郎, 岩屋博道, 有馬志穂, 佐々木文郷, 上村修司, 東美智代, 井戸章雄 . 膵体部癌との鑑別に難渋し、切除標本により診断し得た2型自己免疫性膵炎の1例 . 膵臓35 ( 5 ) 447 - 454 2020.10膵体部癌との鑑別に難渋し、切除標本により診断し得た2型自己免疫性膵炎の1例

Publisher：(一社)日本膵臓学会

症例は46歳女性.心窩部痛,嘔気を主訴に受診した.膵酵素の上昇を認め,急性膵炎の診断で保存的に加療された.画像所見で膵体尾部実質の不均一な造影効果と尾側膵管の拡張を認め,膵腫瘍が疑われた.EUS-FNAにおける組織診断で確定診断が得られなかったが,膵体部癌の可能性が否定できず,手術治療を行った.切除標本にて特徴的な組織所見を示し,2型自己免疫性膵炎の診断に至った.(著者抄録)

Nishikoba N. . HGF-MET Signaling Shifts M1 Macrophages Toward an M2-Like Phenotype Through PI3K-Mediated Induction of Arginase-1 Expression . Frontiers in Immunology11 2135 2020.9

Sasaki S, Hashimoto S, Yamamoto K, Sakaida I . Olmesartan-associated Enteropathy Mimics Endoscopic Findings of Celiac Disease. . Internal medicine (Tokyo, Japan)59 ( 14 ) 1777 - 1778 2020.7Olmesartan-associated Enteropathy Mimics Endoscopic Findings of Celiac Disease.

笠井亜衣, 橋元慎一, 恒吉研吾, 樺山雅之, 岩屋博道, 有馬志穂, 田口宏樹, 上村修司, 東美智代, 井戸章雄 . 膵臓の腫瘤性病変に対するEUS-FNAで診断に至ったB細胞リンパ腫の3例 . 膵臓35 ( 2 ) 213 - 221 2020.4膵臓の腫瘤性病変に対するEUS-FNAで診断に至ったB細胞リンパ腫の3例

Publisher：(一社)日本膵臓学会

膵原発の悪性リンパ腫は,節外性悪性リンパ腫の2%以下,膵悪性腫瘍の0.5%未満と稀である.画像所見のみでは鑑別が難しく,病理組織学的評価による正確な診断が重要である.今回,膵腫瘤に対し超音波内視鏡下穿刺吸引法(EUS-FNA)でB細胞リンパ腫と診断した3例を経験し,うち2例は化学放射線療法で改善した.EUS-FNAは,リンパ腫の病型診断および治療方針決定に有用と考えられた.(著者抄録)

Kurita A. . Comparison of a 22-gauge Franseen-tip needle with a 20-gauge forward-bevel needle for the diagnosis of type 1 autoimmune pancreatitis: a prospective, randomized, controlled, multicenter study (COMPAS study) . Gastrointestinal Endoscopy91 ( 2 ) 373 - 381.e2 2020.2

KASAI Ai, IDO Akio, HASHIMOTO Shinichi, TSUNEYOSHI Kengo, KABAYAMA Masayuki, IWAYA Hiromichi, ARIMA Shiho, TAGUCHI Hiroki, KANMURA Shuji, HIGASHI Michiyo . Three patients with B cell lymphoma diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of pancreatic lesions . Suizo35 ( 2 ) 213 - 221 2020

Publisher：Japan Pancreas Society

Three patients with pancreatic lymphoma were seen. Primary pancreatic lymphoma accounts for less than 2% of extranodal malignant lymphomas and less than 0.5% of malignant tumors of the pancreas. In patients with pancreatic lymphoma, an accurate diagnosis is crucial because the tumor is difficult to distinguish from other pancreatic tumors-especially pancreatic cancer-based on imaging findings alone, and because the treatment depends on the specific type of lymphoma. Two of these patients improved after chemoradiation therapy. EUS-FNA was useful for determining the type of lymphoma and determining the treatment strategy.

DOI： 10.2958/suizo.35.213

YANO Hiroki, IDO Akio, HASHIMOTO Shinichi, TAGUCHI Hiroki, TANOUE Shiroh, IWAYA Hiromichi, ARIMA Shiho, SASAKI Fumisato, KANMURA Shuji, HIGASHI Michiyo . Type 2 autoimmune pancreatitis diagnosed after resection and difficult to differentiate from cancer of the pancreatic body . Suizo35 ( 5 ) 447 - 454 2020

Publisher：Japan Pancreas Society

The patient is a 46-year-old woman admitted with epigastric pain and nausea. She was found to have elevated pancreatic enzymes and treated for acute pancreatitis. Imaging findings showed uneven contrast enhancement of the pancreatic body to tail and enlargement of the caudal pancreatic duct. A pancreatic tumor was suspected. Although no definitive histologic diagnosis was obtained using endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA), the possibility of pancreatic body cancer could not be ruled out, and resection was performed. The resected specimen showed characteristic histologic findings, leading to a diagnosis of type 2 autoimmune pancreatitis.

DOI： 10.2958/suizo.35.447

Kanmura S. . Significance of Linked Color Imaging for Predicting the Risk of Clinical Relapse in Ulcerative Colitis . Gastroenterology Research and Practice2020 3108690 2020

Tanaka A. . Oral administration of Lactobacillus plantarum 06CC2 prevents experimental colitis in mice via an anti-inflammatory response . Molecular Medicine Reports21 ( 3 ) 1181 - 1191 2020

Yamao K. . Endoscopic placement of covered versus uncovered self-expandable metal stents for palliation of malignant gastric outlet obstruction . Gut70 ( 7 ) 1244 - 1252 2020

Language：Japanese Publisher：Gut

Objective Stenting is an established endoscopic therapy for malignant gastric outlet obstruction (mGOO). The choice of stent (covered vs uncovered) has been examined in prior randomised studies without clear results. Design In a multicentre randomised prospective study, we compared covered (CSEMS) with uncovered self-expandable metal stents (UCSEMS) in patients with mGOO; main outcomes were stent dysfunction and patient survival, with subgroup analyses of patients with extrinsic and intrinsic tumours. Results Overall survival was poor with no difference between groups (probability at 3 months 49.7% for covered vs 48.4% for uncovered stents; log-rank for overall survival p=0.26). Within that setting of short survival, the proportion of stent dysfunction was significantly higher for uncovered stents (35.2% vs 23.4%, p=0.01) with significantly shorter time to stent dysfunction. This was mainly relevant for patients with extrinsic tumours (stent dysfunction rates for uncovered stents 35.6% vs 17.5%, p<0.01). Subgrouping was also relevant with respect to tumour ingrowth (lower with covered stents for intrinsic tumours; 1.6% vs 27.7%, p<0.01) and stent migration (higher with covered stents for extrinsic tumours: 15.3% vs 2.5%, p<0.01). Conclusions Due to poor patient survival, minor differences between covered and uncovered stents may be less relevant even if statistically significant; however, subgroup analysis would suggest to use covered stents for intrinsic and uncovered stents for extrinsic malignancies.

DOI： 10.1136/gutjnl-2020-320775

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Maeda H. . Covering Post-Endoscopic Submucosal Dissection Ulcers in Miniature Swine with Hexanoyl (Hx:C6) Group-Modified Alkaline-Treated Gelatin Porous Film (HAG) Induces Proper Healing by Decreasing Inflammation and Fibrosis . Digestion102 ( 3 ) 1 - 13 2020

Language：Japanese Publisher：Digestion

Background and Aims: Hexanoyl (Hx:C6) group-modified alkaline-treated gelatin porous film (HAG) is a newly developed degradable hydrogel characterized by strong adhesiveness and high affinity for vascular endothelial growth factor (VEGF). The aim of this study was to clarify the effect of HAG sheets on the healing process of post-endoscopic submucosal dissection (ESD) porcine gastric artificial ulcers. Methods: (1) To evaluate the adhesiveness of HAG sheets over time, we performed ESD to create 1 artificial ulcer and covered the lesion with 1 HAG sheet using 1 miniature swine. We observed 2 ulcers by endoscopic and microscopic examinations. (2) To examine the effect of HAG sheets on post-ESD ulcer healing, we performed ESD using 5 miniature swine. The artificial ulcers were covered with HAG sheets, or left uncovered after ESD (day 0), followed by macroscopic and microscopic examinations. On days 7 and 14, we observed 2 ulcers by endoscopic examinations. On day 14, the animals were sacrificed, and histological examination was performed on the 3 stomachs that could be extirpated. Results: (1) On day 7, adhesion of HAG sheets was observed. (2) Gastric ulcer area on day 7 was significantly larger in the covered ulcers than in the non-covered ulcers (p = 0.046). On day 14, although there was no significant difference in ulcer area irrespective of covering (p = 0.357), the covered ulcers tended to repair less fold convergence than non-covered ulcers. The covered ulcer sheets significantly decreased inflammatory cell infiltration (p = 0.011), but significantly increased the abundance of macrophages (p = 0.033), in submucosal layers. Also, the abundance of alpha-smooth muscle actin-positive cells in submucosal layers of the covered ulcers was significantly reduced (p = 0.044), leading to a decrease in collagen accumulation. In addition, fibrosis and atrophy of the muscularis propria were significantly lower for covered ulcers than for non-covered ulcers. Furthermore, microvessels and VEGF-positive cells were significantly more abundant in the submucosal layers of the covered ulcers (p < 0.001 and p = 0.024, respectively). Conclusions: HAG sheets induced post-ESD ulcer healing with less submucosal inflammation and muscularis propria injury and have the potential to decrease excess scarring.

DOI： 10.1159/000509056

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Kamikihara Y. . A case of gallbladder neuroendocrine carcinoma diagnosed preoperatively using somatostatin receptor scintigraphy . Oncology Letters19 ( 1 ) 247 - 254 2020

Hiraishi N. . Extract of Lactobacillus plantarum strain 06CC2 induces JNK/p38 MAPK pathway-mediated apoptosis through endoplasmic reticulum stress in Caco2 colorectal cancer cells . Biochemistry and Biophysics Reports20 100691 2019.12

岩下祐司, 橋元慎一, 樋之口真, 藤田俊浩, 岩屋博道, 田ノ上史郎, 田口宏樹, 末吉和宣 . 内視鏡的・外科的乳頭部切除後に主膵管内再発・癌化をきたした十二指腸乳頭部腺腫の1例 . 胆道33 ( 4 ) 752 - 761 2019.10内視鏡的・外科的乳頭部切除後に主膵管内再発・癌化をきたした十二指腸乳頭部腺腫の1例

Publisher：日本胆道学会

症例は67歳、男性。2011年11月に前医で十二指腸乳頭部腺腫に対して内視鏡的乳頭部切除術を施行された。病理結果は管状腺腫であった。2012年2月に局所再発をきたし内視鏡的に切除されたが、遺残があり外科的乳頭部切除術が施行された。2013年5月にも局所再発に対し内視鏡的焼灼術が施行された。以後は再発なく経過したが、2015年7月に急性膵炎を契機に主膵管内に再発が疑われ、当科紹介となった。EUSで膵頭部主膵管内に腫瘤を認め、ERP下の膵管口周囲・膵管内生検で腺腫を認めたことから、十二指腸乳頭部腺腫の局所再発・主膵管内進展と診断し、亜全胃温存膵頭十二指腸切除術を行った。病理組織では膵頭部主膵管内に腺腫腺管の増殖を認め、乳頭部近傍で十二指腸壁及び膵実質への浸潤を呈する浸潤癌に発展していた。乳頭部腺腫局所切除後に再発を繰り返す例では、早期の膵頭十二指腸切除術を考慮する必要があると考えられる。(著者抄録)

Iwaya H. . Laparo-endoscopic rendezvous using a single balloon endoscope for cholecysto-choledocholithiasis in a patient with roux-en Y . Digestive Endoscopy31 ( 5 ) e101 - e102 2019.9

Komaki Yuga, Kanmura Shuji, Tanaka Akihito, Nakashima Mari, Komaki Fukiko, Iwaya Hiromichi, Arima Shiho, Sasaki Fumisato, Nasu Yuichiro, Tanoue Shiroh, Hashimoto Shinichi, Ido Akio . 腸石で誘発された小腸閉塞のため二次性に発症したイレウスに対して経イレウス管コーラ溶解療法は有効である(Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith) . Internal Medicine58 ( 17 ) 2473 - 2478 2019.9腸石で誘発された小腸閉塞のため二次性に発症したイレウスに対して経イレウス管コーラ溶解療法は有効である(Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith)

Publisher：(一社)日本内科学会

症例は87歳女性で、アルツハイマー型認知症に罹患していて寝たきりとなっており、介護施設にて全介助状態にあった。発熱と嘔吐出現のため近医に入院し、腸閉塞と診断された。経鼻胃管チューブを留置され保存的に加療されたが症状は改善せず、画像検査にて小腸に腫瘍疑いの陰影が認められたため、当院に転院となった。腹部超音波検査などの所見から腸石、胆石、ベゾアールなどの結石の存在を疑った。腸閉塞解除のため超細径経鼻内視鏡を用いてイレウス管を挿入したが、小腸内に何らかの物質塊が閉塞しており、胃内には少量の毛髪を含む数個の結石を認めた。ベゾアールに起因にした小腸閉塞を疑い手術を勧めたが患者は同意しなかったため、代わりに経イレウス管コーラ溶解療法を施行した。500mLのコカ・コーラ(pH 1.9)を30分かけて注入する処置を1日2回行ったところ、開始翌日には小腸内の物質塊は半減し、6日目には小腸閉塞とイレウスは完全消退して元の病院へ戻った。回収した石で溶解実験を行ったところ、pH 1.9のコカ・コーラ、pH 1.0および2.0の塩酸、pH 2.6の食用酢のいずれにも溶解することが確認された。

Kanmura S, Hamamoto H, Tanaka A, Arima S, Sasaki F, Tanoue S, Nasu Y, Hashimoto S, Higashi M, Ido A . Diagnostic utility of linked color imaging in the evaluation of colonic mucosal inflammation in ulcerative colitis: a pilot study. . Endoscopy international open7 ( 8 ) E937 - E943 2019.8Diagnostic utility of linked color imaging in the evaluation of colonic mucosal inflammation in ulcerative colitis: a pilot study.

Komaki Y. . Hepatocyte Growth Factor Facilitates Esophageal Mucosal Repair and Inhibits the Submucosal Fibrosis in a Rat Model of Esophageal Ulcer . Digestion99 ( 3 ) 227 - 238 2019.4

Kawabata K. . A high-fructose diet induces epithelial barrier dysfunction and exacerbates the severity of dextran sulfate sodium-induced colitis . International Journal of Molecular Medicine43 ( 3 ) 1487 - 1496 2019.3

Iwashita Yuji, Hashimoto Shinichi, Hinokuchi Makoto, Fujita Toshihiro, Iwaya Hiromichi, Tanoue Shiroh, Taguchi Hiroki, Sueyoshi Kazunobu . A case of recurrence of ampullary adenoma in the pancreatic duct that developed into invasive carcinoma after endoscopic and transduodenal resection . Tando33 ( 4 ) 752 - 761 2019

Publisher：Japan Biliary Association

A 67-year-old man underwent endoscopic papillectomy for ampullary adenoma. The histological findings revealed a tubular adenoma. Endoscopic re-resection and transduodenal resection were performed because the local recurrence of adenoma. Three years later, the patient developed acute pancreatitis, and recurrence in the pancreatic duct was suspected. EUS revealed a low echoic mass in the pancreatic duct, and the pathological findings revealed an adenoma of biopsies from the orifice and pancreatic duct. We diagnosed the recurrence of ampullary adenoma and intraductal extension, and the patient underwent subtotal stomach-preserving pancreaticoduodenectomy. The pathological findings of the resected specimen revealed growth of adenoma in the main pancreatic duct and adenocarcinoma with invasion into the pancreatic parenchyma and duodenal wall. For cases suspected of repeated recurrence after local resection for ampullary adenoma, early pancreaticoduodenectomy should be considered.

DOI： 10.11210/tando.33.752

Fujita T. . Factors associated with the technical success of bilateral endoscopic metallic stenting with partial stent-in-stent placement in patients with malignant hilar biliary obstruction . Gastroenterology Research and Practice2019 5928040 2019

Komaki Yuga, Tanoue Shiroh, Hashimoto Shinichi, Ido Akio, Kanmura Shuji, Tanaka Akihito, Nakashima Mari, Komaki Fukiko, Iwaya Hiromichi, Arima Shiho, Sasaki Fumisato, Nasu Yuichiro . Cola Dissolution Therapy via Ileus Tube Was Effective for Ileus Secondary to Small Bowel Obstruction Induced by an Enterolith . Internal Medicine58 ( 17 ) 2473 - 2478 2019

Publisher：一般社団法人日本内科学会

An 87-year-old bedridden woman developed intestinal obstruction caused by an enterolith or bezoar. Since the patient refused surgery, we administered 1,000 mL/day of cola via an ileus tube to dissolve the stone. Occlusion of the small intestine disappeared on day 6. The excreted stones contained calcium phosphate, which is typical of enteroliths. We later confirmed that the retrieved stones could be dissolved in cola (Coca-Cola®, pH 1.9) as well as 0.10 and 0.010 mol/L hydrochloric acid (pH 1.0 and 2.0, respectively) and food-grade vinegar (pH 2.6). These findings suggest that the enteroliths were dissolved by an acid-base reaction.

DOI： 10.2169/internalmedicine.2745-19

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Ito T. . Analysis of Prognostic Factors in Pancreatic Metastases: A Multicenter Retrospective Analysis . Pancreas47 ( 8 ) 1033 - 1039 2018.9

Hamamoto Hitomi, Hashimoto Shinichi, Taguchi Hiroki, Kojima Issei, Kasai Ai, Tsuneyoshi Kengo, Kuwazuru Kosuke, Arima Shiho, Kanmura Shuji, Ido Akio . 十二指腸壁の陥凹により閉塞性黄疸を発症した好酸球性胃腸炎(Eosinophilic Gastroenteritis in Which Obstructive Jaundice Developed due to Invagination of the Duodenal Wall) . Internal Medicine57 ( 13 ) 1841 - 1847 2018.7十二指腸壁の陥凹により閉塞性黄疸を発症した好酸球性胃腸炎(Eosinophilic Gastroenteritis in Which Obstructive Jaundice Developed due to Invagination of the Duodenal Wall)

Publisher：(一社)日本内科学会

症例は63歳女性で、高熱と心窩部痛が3ヵ月間続いており、上部消化管内視鏡検査で胃十二指腸の浮腫性肥厚が明らかになった。入院時の臨床検査で好酸球増加症と肝胆道系酵素値の上昇などが認められた。十二指腸の超音波内視鏡検査では十二指腸粘膜および筋肉壁が極度に肥厚しており、カプセル内視鏡では空腸の肥厚・浮腫がみられた。画像所見および病理学的所見から混合型の好酸球性胃腸炎と診断した。入院後に黄疸が出現し、腹部CTおよびMRIで総胆管内への十二指腸の陥凹が認められ、この陥凹による胆管閉塞が胆管炎や肝膿瘍の原因であると推測した。十二指腸壁の陥凹は保存療法後に改善したが、十二指腸内腔の狭窄により胆管ドレナージは不可能であった。ステロイドおよび抗アレルギー薬の投与により好酸球性胃腸炎は改善し、再発はみられなかった。

樺山雅之, 佐々木文郷, 前田英仁, 有馬志穂, 田ノ上史郎, 那須雄一郎, 橋元慎一, 上村修司, 門野潤, 井戸章雄 . 審査腹腔鏡が診断に有用であった胃癌術後再発による二次性アカラシアの1例 . 日本消化器病学会雑誌115 ( 4 ) 394 - 400 2018.4審査腹腔鏡が診断に有用であった胃癌術後再発による二次性アカラシアの1例

Publisher：(一財)日本消化器病学会

65歳男性。進行胃癌術後3年目に、嘔吐、体重減少が出現した。各種検査で食道アカラシア様の所見を認めた。(1)壮年層の発症、(2)短い有症状期間、(3)著明な体重減少を三徴とするTucker's criteriaを満たし、二次性アカラシアを疑った。原因として胃癌術後再発を疑い、審査腹腔鏡にて確定診断に至った。二次性アカラシアの診断には、Tucker's criteriaが有用であると考えられた。(著者抄録)

KABAYAMA Masayuki, IDO Akio, SASAKI Fumisato, MAEDA Hidehito, ARIMA Shiho, TANOUE Shiroh, NASU Yuichiro, HASHIMOTO Shinichi, KANMURA Shuji, KADONO Jun . A case of postoperative recurrent gastric cancer resembling esophageal achalasia diagnosed by staging laparoscopy . Nippon Shokakibyo Gakkai Zasshi115 ( 4 ) 394 - 400 2018

Publisher：The Japanese Society of Gastroenterology

A 65-year-old man underwent subtotal gastrectomy for advanced gastric cancer. The histological type of the cancer was signet-ring cell carcinoma, and the clinical stage was stage IB (T2N0M0). Three years after surgery, the patient had the following symptoms:dysphagia, odynophagia, and weight loss. Esophageal endoscopy and esophagography revealed a circular stenosis covered with the normal mucosa between the middle esophagus and the esophagogastric junction. Histologically, the samples obtained by staging laparoscopy revealed signet-ring cell carcinoma. Tucker's criteria are an important tool for differentiating secondary achalasia from primary achalasia with clinical value. Therefore, we suggest that staging laparoscopy is useful for the histological diagnosis of recurrent gastric cancer.

DOI： 10.11405/nisshoshi.115.394

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Hamamoto Hitomi, Ido Akio, Hashimoto Shinichi, Taguchi Hiroki, Kojima Issei, Kasai Ai, Tsuneyoshi Kengo, Kuwazuru Kosuke, Arima Shiho, Kanmura Shuji . Eosinophilic Gastroenteritis in Which Obstructive Jaundice Developed due to Invagination of the Duodenal Wall . Internal Medicine57 ( 13 ) 1841 - 1847 2018

Publisher：一般社団法人日本内科学会

A 63-year-old woman was admitted with epigastric pain, eosinophilia, and elevated hepatobiliary enzyme levels. An upper gastrointestinal endoscopic examination showed that the mucosa of the gastroduodenal wall was edematous. Eosinophilic gastroenteritis (EGE) was diagnosed based on eosinophilic infiltration of the gastroduodenal mucosa. Computed tomography showed invagination of the duodenal wall into the common bile duct. The invagination of the duodenal wall improved after conservative therapy, while bile duct drainage was impossible due to the narrowing of the duodenal lumen. EGE was successfully treated without recurrence with steroids and antiallergic therapy. We herein report a rare case of EGE with obstructive jaundice.

DOI： 10.2169/internalmedicine.9312-17

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Taguchi H. . Helicobacter pylori eradication improves the quality of life regardless of the treatment outcome . Medicine (United States)96 ( 52 ) e9507 2017.12

Hashimoto S. . Diagnostic efficacy of liquid-based cytology for solid pancreatic lesion samples obtained with endoscopic ultrasound-guided fine-needle aspiration: Propensity score-matched analysis . Digestive Endoscopy29 ( 5 ) 608 - 616 2017.7

Hashimoto Shinichi, Taguchi Hiroki, Higashi Michiyo, Hatanaka Kazuhito, Fujita Toshihiro, Iwaya Hiromichi, Nakazawa Junichi, Arima Shiho, Iwashita Yuji, Sasaki Fumisato, Nasu Yuichiro, Kanmura Shuji, Ido Akio . 超音波内視鏡下穿刺吸引法で採取した膵腫瘤性病変検体に対するliquid-based cytologyの診断的有効性　傾向スコアマッチング解析(Diagnostic efficacy of liquid-based cytology for solid pancreatic lesion samples obtained with endoscopic ultrasound-guided fine-needle aspiration: Propensity score-matched analysis) . Digestive Endoscopy29 ( 5 ) 608 - 616 2017.7超音波内視鏡下穿刺吸引法で採取した膵腫瘤性病変検体に対するliquid-based cytologyの診断的有効性　傾向スコアマッチング解析(Diagnostic efficacy of liquid-based cytology for solid pancreatic lesion samples obtained with endoscopic ultrasound-guided fine-needle aspiration: Propensity score-matched analysis)

Publisher：John Wiley & Sons Australia, Ltd

超音波内視鏡下穿刺吸引法(EUS-FNA)で採取した膵腫瘤性病変検体に対するliquid-based cytology(LBC)法とconventional Papanicolaou smear(CPS)法の診断的有効性を比較するため後向き研究を実施した。対象は2009年1月〜2014年8月に当院で腫瘤性病変に対して初回EUS-FNAを施行した患者126例で、このうち63例は2012年5月迄にCPSによる細胞診を施行し、その後63例にLBCによる細胞診を施行した。悪性腫瘍の全発生率は86%であった。LBCはCPSと比較して感度および正診率が高かった。LBCは膵頭部病変の診断において感度が高かった。膵管腺癌(PDAC)の感度もLBCが高かった。多変量解析により、PDAC以外の悪性腫瘍と20mm以下の病変は全参加者においてLBCによる誤診の危険因子であることが明らかになった。以上から、膵腫瘤性病変に対するEUS-FNAにおいてLBCは悪性腫瘍の診断に有用であるが、PDAC以外の悪性腫瘍と小型腫瘍の場合はEUS-FNAとLBCの診断は困難であることが示された。

Ono Y. . The utility of apoptosis inhibitor of macrophages as a possible diagnostic marker in patients with Crohn's disease . BMC Gastroenterology17 ( 1 ) 40 2017.3

Maeda T, Sakiyama T, Kanmura S, Hashimoto S, Ibusuki K, Tanoue S, Komaki Y, Arima S, Nasu Y, Sasaki F, Taguchi H, Numata M, Uto H, Tsubouchi H, Ido A . Low concentrations of human neutrophil peptide ameliorate experimental murine colitis. . Int J Mol Med 2016.12Low concentrations of human neutrophil peptide ameliorate experimental murine colitis.Reviewed

Kozono M, Uto H, Ibusuki R, Arima S, Oda K, Taguchi H, Sasaki F, Nasu Y, Hashimoto S, Setoyama H, Kanmura S, Numata M, Tsubouchi H, Ido A. . Antihypertensive therapy improves insulin resistance and serum levels of interleukin-6 and -10 in spontaneously hypertensive rats with steatohepatitis. . Mol Med Rep 2016.12Antihypertensive therapy improves insulin resistance and serum levels of interleukin-6 and -10 in spontaneously hypertensive rats with steatohepatitis.Reviewed

Hashimoto S, Ito K, Koshida S, Kanno Y, Ogawa T, Masu K, Iwashita Y, Horaguchi J, Kobayashi G, Noda Y . Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis and Stent Dysfunction after Preoperative Biliary Drainage in Patients with Malignant Biliary Stricture. . Intern Med 2016.9Risk Factors for Post-Endoscopic Retrograde Cholangiopancreatography (ERCP) Pancreatitis and Stent Dysfunction after Preoperative Biliary Drainage in Patients with Malignant Biliary Stricture.Reviewed

Yokoyama S, Higashi M, Kitamoto S, Oeldorf M, Knippschild U, Kornmann M, Maemura K, Kurahara H, Wiest E, Hamada T, Kitazono I, Goto Y, Tasaki T, Hiraki T, Hatanaka K, Mataki Y, Taguchi H, Hashimoto S, Batra SK, Tanimoto A, Yonezawa S, Hollingsworth MA . Aberrant methylation of MUC1 and MUC4 promoters are potential prognostic biomarkers for pancreatic ductal adenocarcinomas . Oncotarget 2016.6Aberrant methylation of MUC1 and MUC4 promoters are potential prognostic biomarkers for pancreatic ductal adenocarcinomasReviewed

Hashimoto S, Sendo K, Ido A . Endoscopic double stenting for afferent and efferent loop stenosis in a patient with recurrent gastric carcinoma after Billroth II reconstruction. . Dig Endosc 2016.5Endoscopic double stenting for afferent and efferent loop stenosis in a patient with recurrent gastric carcinoma after Billroth II reconstruction.Reviewed

Kanmura S, Hamamoto H, Morinaga Y, Oda K, Fujita T, Arima S, Nasu Y, Sasaki F, Hashimoto S, Taguchi H, Setoyama H, Ido A. . Fecal Human Neutrophil Peptide Levels Correlate with Intestinal Inflammation in Ulcerative Colitis . Digestion 2016.5Fecal Human Neutrophil Peptide Levels Correlate with Intestinal Inflammation in Ulcerative ColitisReviewed

前田英仁, 橋元慎一, 中澤潤一, 有馬志穂, 田口宏樹, 那須雄一郎, 佐々木文郷, 上村修司, 瀬戸山仁, 門野潤, 東美智代, 井戸章雄 . 胃の瘻孔から主膵管内をNBI（narrow band imaging）拡大観察し得た混合型IPMC（Intraductal Papillary-Mucinous Carcinoma）の一例 . 膵臓 2016.1胃の瘻孔から主膵管内をNBI（narrow band imaging）拡大観察し得た混合型IPMC（Intraductal Papillary-Mucinous Carcinoma）の一例Reviewed

Sasaki F, Kumagai K, Uto H, Takami Y, Kure T, Tabu K, Nasu Y, Hashimoto S, Kanmura S, Numata M, Moriuchi A, Sakiyama T, Tsubouchi H, Ido A. . Expression of glycoprotein nonmetastatic melanoma protein B in macrophages infiltrating injured mucosa is associated with the severity of experimental colitis in mice. . Mol Med Rep 2015.11Expression of glycoprotein nonmetastatic melanoma protein B in macrophages infiltrating injured mucosa is associated with the severity of experimental colitis in mice.Reviewed

Kumagai K, Tabu K, Sasaki F, Takami Y, Morinaga Y, Mawatari S, Hashimoto S, Tanoue S, Kanmura S, Tamai T, Moriuchi A, Uto H, Tsubouchi H, Ido A. . Glycoprotein Nonmetastatic Melanoma B (Gpnmb)-Positive Macrophages Contribute to the Balance between Fibrosis and Fibrolysis during the Repair of Acute Liver Injury in Mice. . PLoS One 2015.11Glycoprotein Nonmetastatic Melanoma B (Gpnmb)-Positive Macrophages Contribute to the Balance between Fibrosis and Fibrolysis during the Repair of Acute Liver Injury in Mice.Reviewed

Makino T, Kanmura S, Sasaki F, Nasu Y, Funakawa K, Tanaka A, Arima S, Nakazawa J, Taguchi H, Hashimoto S, Numata M, Uto H, Tsubouchi H, Ido A . Preoperative classification of submucosal fibrosis in colorectal laterally spreading tumors by endoscopic ultrasonography. . Endosc Int Open 2015.8Preoperative classification of submucosal fibrosis in colorectal laterally spreading tumors by endoscopic ultrasonography.Reviewed

Higashi M, Yokoyama S, Yamamoto T, Goto Y, Kitazono I, Hiraki T, Taguchi H, Hashimoto S, Fukukura Y, Koriyama C, Mataki Y, Maemura K, Shinchi H, Jain M, Batra SK, Yonezawa S. . Mucin Expression in Endoscopic Ultrasound-Guided Fine-Needle Aspiration Specimens Is a Useful Prognostic Factor in Pancreatic Ductal Adenocarcinoma. . Pancreas 2015.7Mucin Expression in Endoscopic Ultrasound-Guided Fine-Needle Aspiration Specimens Is a Useful Prognostic Factor in Pancreatic Ductal Adenocarcinoma.Reviewed

Sasaki F, Kanmura S, Nasu Y, Hashimoto S, Taguchi H, Numata M, Ido A . Double-balloon enteroscopy-assisted closure of perforated duodenal diverticulum using polyglycolic acid sheets. . Endoscopy 2015.6Double-balloon enteroscopy-assisted closure of perforated duodenal diverticulum using polyglycolic acid sheets.Reviewed

Ibusuki K, Sakiyama T, Kanmura S, Maeda T, Iwashita Y, Nasu Y, Sasaki F, Taguchi H, Hashimoto S, Numata M, Uto H, Tsubouchi H, Ido A . Human neutrophil peptides induce interleukin-8 in intestinal epithelial cells through the P2 receptor and ERK1/2 signaling pathways . Int J Mol Med 2015.6Human neutrophil peptides induce interleukin-8 in intestinal epithelial cells through the P2 receptor and ERK1/2 signaling pathwaysReviewed

Funakawa K, Uto H, Sasaki F, Nasu Y, Mawatari S, Arima S, Nakazawa J, Taguchi H, Hashimoto S, Kanmura S, Setoyama H, Numata M, Tsubouchi H, Ido A. . Effect of endoscopic submucosal dissection for superficial esophageal neoplasms and risk factors for postoperative stricture. . Medicine 2015.1Effect of endoscopic submucosal dissection for superficial esophageal neoplasms and risk factors for postoperative stricture.Reviewed

Hashimoto S, Horaguchi J, Fujita N, Noda Y, Kobayashi G, Ito K, Koshida S, Kanno Y, Ogawa T, Masu K. . Intracholecystic papillary-tubular neoplasm of the gallbladder presenting with jaundice. . Intern Med 2014.10Intracholecystic papillary-tubular neoplasm of the gallbladder presenting with jaundice.Reviewed

Taguchi H, Tamai T, Numata M, Maeda H, Ohshige A, Iwaya H, Hashimoto S, Kanmura S, Funakawa K, Fujita H, Ido A, Tsubouchi H. . Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report. . Clin J Gastroenterol 2014.10Endoscopic ultrasonography-guided transmural drainage of an infected hepatic cyst due to Edwardsiella tarda: a case report.Reviewed

Komaki Y, Kanmura S, Funakawa K, Komaki F, Hashimoto S, Taguchi H, Numata M, Fujita H, Uto H, Ido A, Tsubouchi H. . A case of hereditary hemorrhagic telangiectasia with repeated hemobilia arrested by argon plasma coagulation under direct peroral cholangioscopy . Gastrointest Endosc. 2014.9A case of hereditary hemorrhagic telangiectasia with repeated hemobilia arrested by argon plasma coagulation under direct peroral cholangioscopyReviewed

橋口正史, 重田浩一朗, 宇都浩文, 肱黒薫, 長谷川将, 風呂井彰, 橋元慎一, 井戸章雄, 東美智代, 藤崎邦夫 . 術前診断に経鼻内視鏡を用いた直接経口胆道鏡が有用であったIntraductal papillary neoplasm of the bile ductの一例 . 肝臓 2014.8術前診断に経鼻内視鏡を用いた直接経口胆道鏡が有用であったIntraductal papillary neoplasm of the bile ductの一例Reviewed

Ito K, Horaguchi J, Fujita N, Noda Y, Kobayashi G, Koshita S, Kanno Y, Ogawa T, Masu K, Hashimoto S . Clinical usefulness of double-guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatography . Dig Endosc 2014.5Clinical usefulness of double-guidewire technique for difficult biliary cannulation in endoscopic retrograde cholangiopancreatographyReviewed

Obana T, Fujita N, Ito K, Noda Y, Kobayashi G, Horaguchi J, Koshita S, Kanno Y, Ogawa T, Hashimoto S, Masu K . Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosis . Dig Endosc 2013.11Therapeutic endoscopic retrograde cholangiography using a single-balloon enteroscope in patients with Roux-en-Y anastomosisReviewed

Kanno Y, Ito K, Fujita N, Noda Y, Kobayashi G, Horaguchi J, Koshita S, Ogawa T, Masu K, Hirasawa D, Sugawara T, Koike Y, Hashimoto S, Ishii S. . Efficacy and safety of a WallFlex enteral stent for malignant gastric obstruction . Dig Endosc 2013.7Efficacy and safety of a WallFlex enteral stent for malignant gastric obstructionReviewed

Noda Y, Fujita N, Kobayashi G, Ito K, Horaguchi J, Hashimoto S, Koshita S, Ishii S, Kanno Y, Ogawa T, Masu K, Tsuchiya T, Oikawa M, Honda H, Sawai T, Uzuki M, Fujishima F. . Prospective randomized controlled study comparing cell block method and conventional smear method for bile cytology . Dig Endosc 2013.7Prospective randomized controlled study comparing cell block method and conventional smear method for bile cytologyReviewed

Nasu Y, Ido A, Tanoue S, Hashimoto S, Sasaki F, Kanmura S, Setoyama H, Numata M, Funakawa K, Moriuchi A, Fujita H, Sakiyama T, Uto H, Oketani M, Tsubouchi H . Hepatocyte growth factor stimulates the migration of gastric epithelial cells by altering the subcellular localization of the tight junction protein ZO-1. . J Gastroenterol 2013.2Hepatocyte growth factor stimulates the migration of gastric epithelial cells by altering the subcellular localization of the tight junction protein ZO-1.Reviewed

Ishii S, Kobayashi G, Fujita N, Noda Y, Ito K, Horaguchi J, Koshita S, Kanno Y, Ogawa T, Masu K, Hashimoto S, Sawai T, Uzuki M . Undifferentiated carcinoma of the pancreas involving intraductal pedunculated polypoid growth . Intern Med 2012.12Undifferentiated carcinoma of the pancreas involving intraductal pedunculated polypoid growthReviewed

Horaguchi J, Fujita N, Noda Y, Kobayashi G, Ito K, Koshita S, Kanno Y, Ogawa T, Masu K, Hashimoto S, Ishii S . Metallic stent deployment in endosonography-guided biliary drainage: long-term follow-up results in patients with bilio-enteric anastomosis . Dig Endosc 2012.11Metallic stent deployment in endosonography-guided biliary drainage: long-term follow-up results in patients with bilio-enteric anastomosisReviewed

1.Hashimoto S, Uto H, Kanmura S, Sakiyama T, Oku M, Iwashita Y, Ibusuki R, Sasaki F, Ibusuki K, Takami Y, Moriuchi A, Oketani M, Ido A, Tsubouchi H. . Human neutrophil peptide-1 aggravates dextran sulfate sodium-induced colitis. . Inflamm Bowel Dis 2012.4Human neutrophil peptide-1 aggravates dextran sulfate sodium-induced colitis.Reviewed

Hashimoto S, Uto H, Kanmura S, Sakiyama T, Oku M, Iwashita Y, Ibusuki R, Sasaki F, Ibusuki K, Takami Y, Moriuchi A, Oketani M, Ido A, Tsubouchi H. . Human neutrophil peptide-1 aggravates dextran sulfate sodium-induced colitis. . Inflamm Bowel Dis.18 ( 4 ) 667 - 675 2012.1Human neutrophil peptide-1 aggravates dextran sulfate sodium-induced colitis.Reviewed

Tanoue S, Uto H, Kumamoto R, Arima S, Hashimoto S, Nasu Y, Takami Y, Moriuchi A, Sakiyama T, Oketani M, Ido A, Tsubouchi H . Liver regeneration after partial hepatectomy in rat is more impaired in a steatotic liver induced by dietary fructose compared to dietary fat . Biochem Biophys Res Commun 2011.4Liver regeneration after partial hepatectomy in rat is more impaired in a steatotic liver induced by dietary fructose compared to dietary fatReviewed

1.Kanmura S, Uto H, Numata M, Hashimoto S, Moriuchi A, Fujita H, Oketani M, Ido A, Kodama 　M, Ohi H, Tsubouchi H. . Human neutrophil peptides 1-3 are useful biomarkers in patients with active ulcerative colitis . Inflamm Bowel Dis 2009.6Human neutrophil peptides 1-3 are useful biomarkers in patients with active ulcerative colitisReviewed

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